Chapter 33 Nursing Management Hypertension

The lack of knowledge and confidence of obtaining a manual blood pressure is an ever growing issue in the healthcare field. This paper will outline the importance of taking a manual blood pressure accurately. Providing the proper blood pressure measurement can determine a patient’s care and outcome when in a healthcare facility. I will talk about the pros and cons of manual blood pressures and personal experience of this vital skill in the healthcare field. I will also provide some simple but effect ways to increase confidence and knowledge by just basic education. All of my information and numbers will be supported by using references and studies in the use of manual blood pressure monitoring.

4. What tips can you give KH’s wife to improve the accuracy of her blood pressure measurement technique? Used the better way to measure the blood and for the cuff to wrap

(Marieb and Hoehn, 2010, p 703) defined Blood Pressure (BP) as ‘the force per unit area exerted on a vessel wall by the contained blood, and is expressed in millimetres of mercury (mm Hg)’. BP is still one of the essential and widely used assessment tools in healthcare settings. Nurses generally record the arterial BP which is the forced exerted blood that flows through the arteries, to establish a baseline and to determine any risk factors. BP

An evaluation of Mrs Smith circulation was the next step carried out by the nurse, as in the breathing assessment Mrs Smith pallor was noted as being flushed and the patient appeared confused this could be associated with poor cardiac output. The nurse recorded the patient’s blood pressure using a dinamap it was measured at 88/50, it was then rechecked manually to ensure accuracy. The pulse was checked manually for rate and rhythm it was recorded as 98 beats per minute. Capillary refill was checked, was found to be normal.

8. Which of the following information from the medical charts appears to play the least role in determining blood pressure?

The diagnosis of hypertension is not made until the client has an elevated blood pressure on two different occasions.

and the information from this case to explain each of the following aspects of blood pressure and discuss

25) A 62 year-old woman comes to the ER with complaint of breathing difficulty and chest pain. Her blood pressure is 88/58. After the patient is placed on the cardiac monitor, the rhythm is as shown below. What is the best action that the nurse should take for the patient?

When checking for orthostatic changes in vital signs the nurse should measure the serial blood pressure and take the pulse of a patient in the supine, sitting, and standing positions. The nurse should first start by placing the patient in the supine position and allowing the patient to rest for 2 to 3 minutes before taking the blood pressure. Next, the nurse should place the patient in the sitting position with their legs dangling off the side of the bed. Then the nurse should allow the patient to rest for 1 to 2 minutes before measuring the blood pressure once again. Lastly, the nurse should reposition the patient to the standing position and should allow 1 to 2 minutes of rest before proceeding to the last blood pressure measurement. Orthostatic changes in the patients pulse and blood pressure need to be monitored closely because they can indicate signs of dehydration concerning the gastrointestinal system. Usually while the patient is in the standing position the systolic blood pressure will decrease 10 mm Hg, and the diastolic blood pressure will increase a bit. Now, when the systolic blood pressure decreases by 20 mm Hg, the diastolic blood pressure decreases by 10 mm Hg or higher, and there could be no change in heart rate or there could be an increase in the heart rate of 20 beats/minute or higher while reposition from the supine position to the

After all the medications were given Mr. B’s vitals were as follows: Blood Pressure (BP) of

The pulse is an indication of an individual’s heart rate. When checking for a pulse in the primary survey, begin with palpating the patient’s radial or carotid artery (Basic Patient Care 2012, p. 50). This may reveal a normal (60-100 beats/min), tachycardia (<100 beats/min), bradycardia (> 60 beats/min) or asystole heart rate. Additionally, the capillary refill may also provide details about a patient’s cardiovascular status. This is performed by applying pressure to the nail bed and calculating the time it to takes to refill to a normal color, which should take no more then a few seconds otherwise suggesting capillary closure (Mick J Sanders, 2012, p. 1400). An additional accessory to Circulation is Hemorrhages, these involve more through examinations of the pulse, blood pressure and warmth of peripheries of patients. Additionally, you must thoroughly look for indication of bleeding, specifically in the areas around the chest, abdomen and externally seen by the eye.

In this scenario, the subjected data is chest palpitation, lightheadedness and dizziness, the objective data is elevated heart rate with irregular rhythm, orthostatic blood pressure readings, lying 135/90, sitting 120/80, standing 100/60, and the client becoming dizzy and light-headed as he moves from a sitting to a standing position while taking the blood pressure. The subjective and objective data indicates that the patient has orthostatic hypotension. To determine what is causing the orthostatic hypotension a more in-depth health history, physical assessment, labs and diagnostic testing would need to be done.

I have selected case number 1. An 85 year old man came to the emergency room with palpitations for a few days. He states that he sometimes feels light headed and dizzy. The patient’s heart rate is elevated and irregular. As he goes from a sitting position to a standing position he becomes light headed and dizzy. In taking orthostatic blood pressure you notice that they are positive.

On the first page of the introduction, line 23, the authors state: Yung et al. (2014) developed a distinctive dose using anterior-to-posterior pressures (AP) of the cervical spine that resulted in a reduction in systolic blood pressure (SBP) and heart rate (HR),

The patient vital signs are normal except for his blood pressure which is 146/89. The medical assistant informs the patient that his blood pressure is high and questions about his day and diet. The patient did have a full day of school before rushing to the office.