Copyright Goodheart-Willcox Co., Inc. Chapter 18 Vital Signs, Height, and Weight 475 Taking a Resident’s Blood Pressure Blood pressure can be measured manually or electronically, depending on the equipment available. Both ways are accu- rate however, electronic devices reduce potential human error as long as they are checked regularly for accuracy. Equipment may be movable, on a wall mount, or part of an electronic vital sign monitoring machine. When taking a resident’s blood pressure, be sure to check the equipment, make sure the resident is relaxed, and ensure you feel prepared to perform the procedure. Avoid using an arm with an IV catheter, cast, wound, or injury to take blood pressure. Residents who have undergone a mastectomy should not have blood pressure taken on the same side as the breast removal. It is important to recheck a blood pressure reading if you are not sure the measurement is accurate or if you cannot hear the sounds clearly. You should recheck blood pressure if you suspect an error or faulty equipment, if you notice a change in the resident’s normal blood pressure, or if the reading is the first occurrence of high or low blood pressure for that resident. If retaking a blood pressure, be sure the blood pressure cuff is completely deflated with all of its air released. Wait one minute before retrying. Also check the stethoscope to be sure it is working correctly and is placed in the correct location. Be sure the earpieces are properly located in your ears. When taking a manual blood pressure measurement, you will need a stethoscope and a sphygmomanometer (sphygm/o = pulse man/o = pressure -meter = measure). Before beginning, check that the stethoscope is in working order. There are two main types of sphygmomanometers used to measure blood pressure (Figure 18.26): 1. Manual aneroid sphygmomanometer: is movable and has a round dial and a needle that points to the numbers. You will need to use a stethoscope when using this device. 2. Electronic sphygmomanometer: has a digital display and is found in many healthcare facilities. You will not need a stethoscope when using this device. A sphygmomanometer has two parts: the measuring device and the cuff. When applying a blood pressure cuff, check that it is the right size. Cuffs come in various sizes—pediatric, small adult, adult, and large adult (Figure 18.27). If the cuff is too small or too large, the blood pressure reading will not be accurate. The inflatable part of the cuff should cover two-thirds of the distance from the elbow to the shoulder. You should be able to fit your fingers between the closed cuff and the skin. No matter what type of device you use, be sure it is in working order before taking blood pressure. Before taking blood pressure, have residents relax or rest for a few minutes (five minutes). This will help you get a reading that is most normal for the resident. The blood pressure reading may not be accurate if the resident has just been exercising, is in pain, is feeling anxious, or has recently had physical therapy. If possible, wait at least 30 minutes after these events before taking a routine blood pressure measurement. Also make sure the area in which blood pressure is taken is quiet. This will help you hear through the stethoscope and better ensure accuracy of the measurement. Taking blood pressures can seem challenging at first, but practice helps build confidence and will improve your ability to hear through the stethoscope and take accurate readings. A B sirtravelalot/Shutterstock.com Pro3DArtt/Shutterstock.com Figure 18.26 Both manual (A) and electronic (B) sphygmomanometers can be used to measure blood pressure. Wards Forest Media, LLC Figure 18.27 Using the appropriate cuff is important for getting an accurate measurement.