Blood pressure

Prehypertensive lifestyle modification

lose weight

Diet rich in fruits and veggies; low in fat and cholesterol

Reduce sodium intake

Aerobic exercise more than or equal to 150 min/week

Limit alcohol consumption

Resting BP Technique

Bell of stethoscope is over brachial artery

inflate cuff about 20-30 mmHg above estimated SBP

Release pressure slowly, listening for 1st Korotkoff sound

Identify muffling

No longer hear diastolic

Sources of Error

Inaccurate sphygnonometer

Improper cuff width or length

Cuff too loose, over clothing or rolled up sleeves

Poor auditorily acuity of the technician

Improper inflation or deflation of cuff pressure

Sources of Error cont

Technician bias

slow reaction time

parallax error in reading the mano meter

background noise patient clinching the treadmill or cycle ergometer

Sphygmomanometers

Mercury columns are most accurate

use of mercury column manometers is restricted due to environmental concerns

Various agencies judge the accuracy of manometers (AAMI, BHS,EHS-IP)

Hybrid (electronic and auscultatory) devices are gaining popularity as the standard

Automated BP devices

Automated devices eliminate technician bias

Arm devices are more accurate than wrist or finger devices

Validity varies based on devices

Automated devices have not been validated for use during exercise

Hypertension Phenomena

White coat hypertension

Masked hypertension

cuff hypertension

Measuring exercise BP

Client should not grasp handlebars or handrails

have tubing protruding from bladder superior instead of inferior

stabilize client’s arm between your arm and trunk

position manometer at eye level

inflate cuff well above anticipated value

Classification of resting heart rate

les than 60 bpm = bradycardia

60 to normal bpm = normal

great than 100 = tachycardia

Locations for heart rate measurement

Palpation (Brachial artery, Carotid artery, Radial artery, temporal artery)

HR Palpation Technique

Use tips of index and middle fingers

apply light pressure start stopwatch simultaneously with pulse beat; 1st beat is zero

Duration- rest 30 to 60 sec exercise 10 sec

What effects resting heart rate

Fitness level, stress/emotions, sleep, stimulants, alcohol, hydration, age and body size, circadian rhythm, temperature and environment, body position