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Blood Pressure

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The force of the blood, as it is being pumped from the ventricles, as it pushes ... Sphygmomanometer (yes..spelling counts). Labeling the equipment (cuff) Cuff ... – PowerPoint PPT presentation

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Title: Blood Pressure


1
Blood Pressure
  • Mm/hg

2
What is Blood Pressure?
  • The force of the blood, as it is being pumped
    from the ventricles, as it pushes against the
    walls of your arteries.

3
Two important numbers
  • Systolictop number
  • Diastolicbottom number
  • 120/80
  • Systolecontraction of the heart
  • Diastolerelaxation of the heart

4
Systolic
  • Represents the force of the blood as it pushes
    against the wall of the arteries.
  • When the ventricles contract.
  • Blood is forced out of the aorta and pulmonary
    artery.
  • Pressure in the arteries is highest during
    systole.

5
Diastolic
  • Force of the blood in the arteries when the
    ventricles are relaxing.
  • Blood flows back into the two ventricles and
    dilates them therefore, pressure in the arteries
    is lower.

6
So What?
  • Systolic readings tell the MD about the condition
    of your left ventricle.
  • Diastolic readings tell the MD about the
    resistance of your blood vessels.
  • Resistance how much give there is.
    Remember..arteries are supposed to be pliable.

7
Systolic vs. Diastolic
  • Diastolic is typically more of a concern because
    it tells us what type of strain your arteries are
    under.
  • If, during diastole, the pressure is supposed to
    be lower in the arteries, but it isnt, then the
    arteries really are not getting a break. They are
    taking a constant pounding.

8
Diastolic continued.
  • The condition of your peripheral vessels also
    plays a part in the diastolic pressure.
  • If you have arteriosclerosis, how pliable are
    your arteries? Not very.
  • People with arteriosclerosis have higher BP.

9
Pulse Pressure
  • The numeric difference between systolic and
    diastolic.
  • 120/80pulse pressure is 40
  • 180/90pulse pressure is 90
  • Pulse pressure is indicative of the tone of your
    arteries.
  • 40 is normal.

10
Factors that determine BP
  • Pumping action of the heart (60-80 bpm or 100,000
    times a day)
  • Volume of blood within the vessels (we have six
    quarts)
  • Peripheral resistance of vessels to the flow of
    blood.
  • Elasticity of the walls of the main arteries.
  • Viscosity of the blood.

11
Vocabulary
  • Page 86

12
Hypertension
  • Benign Slow onset, asymptomatic
  • Secondary We can find a cause for it (kidney
    disease).
  • Malignant Rapid onset. Can be fatal.
  • Essential Idiopathic. Occurs in the absence of
    kidney disease. most common.

13
Hypotension
  • Orthostatic hypotension (postural)
  • Postural hypotension (orthostatic)
  • Orthostatic BP

14
Normal for adults
  • Textbook perfect 120/80
  • Ranges for systolic 90-140 mm/hg
  • Ranges for diastolic 60-90 mm/hg
  • Remember In older adults due to vascular
    changes, decreased peripheral resistance,
    arteriosclerosis, these numbers may go up.

15
Up and Down
  • Up Exercise, stress, arteriosclerosis, increased
    peripheral resistance, increased weight, smoking,
    pain, kidney disease, drugs, etc.
  • Down Cardiac failure, MI, shock, dehydration,
    sleep, approaching death, etc.

16
The Silent Killer
  • Hypertension

17
Hypertension
  • One visit to the MD with HTN does not mean you
    have HTN.
  • You have to have 3 consecutive readings that are
    above the normal limit.
  • Borderline 140/90

18
Damage
  • If HTN goes untreated, a wealth of problems can
    occur without the patient being aware until it is
    too late.
  • Damage to kidneys, heart, eyes, arteries, etc.

19
Prevention Detection
  • All adults, 18 or over, with a diastolic BP of
    110 mm/hg or over---see MD immediately.
  • All people with BP between 160/100-179/109 mm/hg
    should have it confirmed within 1 month.
  • All people with BP between 140/90-159/99 mm/hg
    should be checked every two months.
  • All others, annually.

20
Evaluationwhere to start
  • Nothing beats a good History.
  • Followed by a Physical Exam.
  • Followed by Basic Lab Tests.
  • Always include your patient in the Plan of Care.

21
Myths
  • If I had high blood pressure, I could feel
    it.
  • I feel fine so I am not going to take my
    medication today.

22
Equipment Needed
  • Blood pressure cuff (NOT CUP)
  • Sphygmomanometer (yes..spelling counts).

23
Labeling the equipment (cuff)
  • Cuff
  • Pressure control valve
  • Gauge pressure indicator
  • Inflation bulb

24
Labeling the stethoscope
  • Earpieces
  • Binaurals
  • External spring
  • Tapered tubing
  • Diaphragm
  • Chestpiece

25
The Phases of Blood Pressure (V)
  • Phase I First series of faint but clear
    tapping. Gradually increases in intensity.
  • Phase II As you deflate the cuff, the sounds
    change to a swish. Sound might disappear but
    reappear (ausculatory gap)
  • Phase III Sounds crisp and loudas you reopen
    the artery.
  • Phase IV Sounds become dull and muffledthis is
    first diastole.
  • Phase V The sound disappearsrecord this number.

26
When you cant use the arm!
  • Palpating a BP.
  • Using the leg.
  • You cant use the arm when (1) mastectomy, (2)
    IV, (3) cast, (4) stroke affected side.

27
Obtaining the BP and Orthostatic BP.
  • Call for volunteer.

28
FinallyHeight and Weight
  • Practice with the old and put together the new.
  • Convert lbs. to kilograms and kilograms to
    pounds.
  • Convert inches to feet and feet to inches.

29
Pass Off Mondayall day!
  • Bring a partner
  • Wear your uniform
  • Do NOT ask me on Monday if you are doing it
    right.
  • Do NOT tell me you havent practiced because you
    have had open lab time.
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