364 Chapter 16 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. 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. • Position: blood pressure may be higher if a resident is lying down and lower if a resident is standing up. • Cigarettes and alcohol: using cigarettes and alcohol can increase blood pressure. • Drugs or medications: some medications and drugs can make blood pressure higher or lower. • Stress, fear, or pain: blood pressure may be higher if a resident is feeling stress, fear, or pain. Taking a Resident’s Blood Pressure Blood pressure can be measured manually or electronically. Both ways are accurate however, electronic devices reduce potential human error. 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 be prepared to perform the procedure. Avoid using an arm with an IV, cast, wound, or injury to take blood pressure. Residents who have had 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 this is the first time the blood pressure is high or low for this resident, or you notice a change in the resident’s normal blood pressure. 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 16.21): 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. THINK ABOUT THIS The Centers for Disease Control and Prevention recently reported that 75 million American adults (29 percent) have high blood pressure. This means that about one in every three adults has hypertension. Approximately one-half (54 percent) of those with high blood pressure have their condition under control. A B sirtravelalot/Shutterstock.com Pro3DArtt/Shutterstock.com Figure 16.21 Both manual (A) and electronic (B) sphygmomanometers can be used to measure blood pressure. Copyright Goodheart-Willcox Co., Inc.