Week 3 MA 114 In Person Quiz

normal blood pressure range

less than 120/less than 80

both systolic & diastolic numbers must be in this range to be considered “normal”

elevated blood pressure range

120-129/less than 80

both systolic & diastolic numbers must be in this range to be considered “elevated”

hypertension stage 1 range

130-139/80-89

only the systolic OR diastolic number must be in this range to be considered “stage 1”

hypertension stage 2 range

140 or higher/90 or higher

only the systolic OR diastolic number must be in this range to be considered “stage 2”

hypertensive crisis range

higher than 180/higher than 120

only the systolic OR diastolic number is needed in this range to be considered “hypertensive crisis”

If a reading of 140/90 or higher is obtained

it is often indicated to take another reading a bit later before leaving, to have two measurements for accuracy and to see if any change occurred

blood pressure cuff

comes in different sizes

includes the:

cuff

bulb

valve

tubing

sphygmomanometer (gauge)

stethoscope

instrument used to hear sounds in the patient’s body, this examination technique is called auscultation

parts include:

earpieces

binaural tubes

rubber or plastic tubing

chestpiece (bell & diaphragm)

equipment needed to take blood pressure

blood pressure cuff

stethoscope

how should a patient be sitting when taking blood pressure

sitting comfortably, with their feet flat and supported, and arm resting at heart level

and ideally their upper and lower arm should be bare, having removed or lifted clothing out of the way

cuff placement

at least 1 inch above the elbow crease

stethoscope bell placement

over the brachial artery at the elbow crease

should be placed over bare skin and not underneath any part of the cuff

how much should you initially fill the cuff

30 mmHg above what the patient’s anticipated systolic reading will be

how fast should the needle fall when the valve is being slowly released

2 mmHg per second

how long should you release the air after the last sound heard

at least 10 mmHg

systolic number

the top number

the first audible heartbeat heard

diastolic number

the bottom number

the last audible heartbeat sound heard

pulse obliteration

gives the anticipated systolic range

the five phases of korotkoff sounds

phase 1: the first tapping sound you hear represents the systolic pressure

phase 2: a string heartbeat changes to a softer, swishing sound

phase 3: a crisp, tapping sound resumes

phase 4: sounds become muffled

phase 5: the point at which the sound disappears; this represents the diastolic pressure

how should aneroid sphygmomanometers be read

as even numbers only

non-disease related blood pressure variance factors

age (down in children, up in elderly, opposite of age pulse relation)

recent activity (up)

anxiety, stress, pain (up)

fitness level (resting pulse rates down with prolonged physical fitness)

caffeine (up)

smoking (up)

disease related blood pressure variance factors

many diseases can cause temporary increase in blood pressure

diagnosis of hypertension cannot be made by just one reading

hypertension along with its partner atherosclerosis, are silent killers. together they are the precursor for chronic vascular and heart disease, which is the number 1 killer in the USA and the world, per the WHO.

medical assistant controlled factors

improper cuff size

poor cuff positioning on upper arm

arm not at heart level

feet not supported

patient silence

needle fall rate

blood pressure should not be taken on an arm

that is on the same side as a mastectomy (breast removal)

that has an injury

a blocked artery

or a device under the skin (implant) at the site

some patient’s arms are too large for large cuffs, which may lead to taking blood pressure on the forearm, thigh, or calf

steps of taking orthostatic blood pressure

1. Have the patient lie down for 5 minutes (minimum of 3 minutes required)

2. Measure blood pressure and pulse

3. Have the patient stand (assistance may be needed as patients can feel lightheaded or dizzy)

4. Note any symptoms the patient may be experiencing

5. Measure blood pressure and pulse after 1 minute of standing

6. Measure blood pressure and pulse after 3 minutes of standing

abnormal orthostatic blood pressure drop

Any drop in blood pressure of 20 mmHg or greater would be considered abnormal.

A drop in diastolic blood pressure of 10 mmHg or greater would be considered abnormal.

Symptoms of lightheadedness or dizziness would also indicate an abnormal test.