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LL3b VITAL SIGNS BLOOD PRESSURE

LL3b VITAL SIGNS BLOOD PRESSURE. The force exerted by the blood against the vessel walls. Blood Pressure (BP) reflects the balance of cardiac output; peripheral vascular resistance; blood volume; blood viscosity; elasticity of arteries;

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LL3b VITAL SIGNS BLOOD PRESSURE

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  1. LL3b VITAL SIGNSBLOOD PRESSURE • The force exerted by the blood against the vessel walls. • Blood Pressure (BP) reflects the balance of cardiac output; • peripheral vascular resistance; • blood volume; blood viscosity; • elasticity of arteries; and is influenced by age, stress, race, medication and diurnal variation. sj/LL3b/P&BP

  2. MEASUREMENT • The measurement indicates the height at which the BP can raise the column of mercury (or other measurement means) as per visual gauge. • BP is measured by means of a standard unit of measurement - millimetres of mercury in a column (mmHg) or KiloPascals (S.I. unit) sj/LL3b/P&BP

  3. BP reflects HAEMODYNAMIC FACTORS within the Circulatory System • It is the product of Cardiac Output (CO) & Peripheral resistance (PR) - BP = CO X R sj/LL3b/P&BP

  4. BP varies in different blood vessels. • Clinically the term BP refers to Systemic arterial blood pressure. • There is no such value as a "normal" BP because it varies from individual to individual AND from moment to moment - • but a NORMAL BP RANGE can be taken as between 100 / 60 --- 150 / 90 mmHg sj/LL3b/P&BP

  5. FACTORS AFFECTING BLOOD PRESSURE • Age, gender, race/ethnic origin, emotion, exercise, sleep, time of day, state of digestion / ingestion of food • The Autonomic Nervous System + Renin- Angiotensin - Aldosterne System is responsible for controlling the BP and keeping it within the normal range. sj/LL3b/P&BP

  6. SYSTOLIC PRESSURE - is determined by the amount of blood being forced into the aorta and arteries with each ventricular contraction • DIASTOLIC PRESSURE - provides information about the degree of Peripheral Resistance and depends on the level of the systolic pressure. sj/LL3b/P&BP

  7. PRACTICAL CONSIDERATIONS WHEN RECORDING BP's • Explanation, patients reaction, variability in BP; posture of client • Position of arm; application of cuff; position of manometer • Estimation of systolic pressure; number of measurements; times of measurement sj/LL3b/P&BP

  8. Ausculatory measurement of systolic & diastolic pressure; • indications for measurement on both or only one arm; • measurement re: children; • follow up measurement - how often and why? sj/LL3b/P&BP

  9. MEASUREMENT SOUNDS Korotkov Sounds ( based on O'Brien & O'Malley 1981) • Phase Sound mmHg Pressure • 1 Sharp, clear 120 Systolic • 2 Blowing. swishing 110 • 3 Sharp, but softer than in 1 90 ) • 4 Muffled, fading 80 ) Diastolic • 5 No sound <80 sj/LL3b/P&BP

  10. HYPERTENSION If a reduced arterial wall elasticity exits (eg arteriosclerosis) there is greater resistant to blood flow - BP rises. Systolic pressure is more elevated than the diastolic. • DIAGNOSIS - is made when - 2 or more diastolic readings are 90 mmHg or higher OR Systolic reading is more than 140 mmHg sj/LL3b/P&BP

  11. HYPOTENSION • A persistently low BP is relatively uncommon but conditions of temporary lowered BP are more common. eg: haemorrhage or fainting • Low BP can be associated with illness state and has the potential to be life threatening. sj/LL3b/P&BP

  12. PULSE • A peripheral pulse - wave that travels through the arterial system following the ejection of the cardiac ventricle against the walls of the aorta. • Pulse is palpated by lightly compressing the artery against underlying bone or muscles • Assessing a pulse offers valuable data for determining the integrity of the cardio vascular system(CVS) sj/LL3b/P&BP

  13. Pulse rate indirectly measures the hearts output. • Slow OR Rapid OR Irregular pulse may indicate the hearts inability to deliver an adequate cardiac output. • Pulse Strength indicates volume of blood being ejected. • The Peripheral pulse indicates the status of blood perfusion to the area served by that arterial pathway - eg femoral pulse in the leg sj/LL3b/P&BP

  14. References: • Potter,A. Perry,A. (1997) Fundamentals of Nursing, Concepts, Process & Practice St Louis: Mosby Ch 32 p 594 • Taylor,C. Lillis,C. LeMonde,P. (1997) Fundamentals of Nursing - The Art & Scienceof Nursing Care. Philadelphia: Lippincott Ch25 p432 sj/LL3b/P&BP

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