Vital Signs, Height, and Weight 365 If possible, wait at least 30 minutes after these events before taking a routine blood pressure measurement. Also make sure the room or area in which blood pressure is taken is quiet. This will help you better hear through the stethoscope. 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. Procedure Taking a Blood Pressure Rationale Blood pressure measures the force of blood pushing against the body’s arterial walls. A blood pressure reading outside the normal range may be a sign of a disease or health issue. Preparation 1. Ask the licensed nursing staff how this procedure fits into the plan of care, if there are doctor’s orders for the procedure, if there are any special instructions or precautions, and if the resident can be moved into the positions required for this procedure. 2. Wash your hands or use hand sanitizer before entering the room. 3. Knock before entering the room. 4. Introduce yourself using your full name and title. Explain that you work with the licensed nursing staff and will be providing care. 5. Greet the resident and ask the resident to state his full name, if able. Then check the resident’s identification bracelet. 6. Use Mr., Mrs., or Ms. and the last name when conversing. 7. Explain the procedure in simple terms, even if the resident is not able to communicate or is disoriented. Ask permission to perform the procedure. 8. Bring the necessary equipment into the room. Place the following items in an easy-to-reach place: • a sphygmomanometer • an appropriately sized cuff • a stethoscope, if using a manual sphygmomanometer • antiseptic wipe(s) • disposable paper cover, if needed • a pen and pad, form, or digital device for documenting the blood pressure The Procedure: Manual Device 9. Provide privacy by closing the curtains, using a screen, or closing the door to the room. 10. Clean the cuff with an antiseptic wipe or cover it with a disposable paper cover. 11. Have the resident rest quietly and lie comfortably on the bed or sit in a chair. Make sure the room is quiet. 12. When appropriate, let the resident choose which arm he wants you to use for taking blood pressure and whether he wants to sit up or lie down. 13. If the resident is in bed, lock the bed wheels and then raise the bed to hip level. If he is on an examining table, stand next to him or sit in a chair in front of him so you can get a clear view of the dial. 14. Clean the earpieces of the stethoscope with an antiseptic wipe and warm the diaphragm with your hands before cleaning it with antiseptic wipes. 15. Position the resident’s arm so it rests level with the heart with the palm turned upward. Provide support, if needed (Figure 16.22). Figure 16.22 Best Practice: Expose the upper arm so that you can place the cuff on bare skin. 16. Unroll the blood pressure cuff and loosen the valve on the bulb of the sphygmomanometer by turning it counterclockwise (Figure 16.23). (continued) Copyright Goodheart-Willcox Co., Inc.