Blood Pressure

Front 1

Blood pressure?

Back 1

The force exerted on the walls of an artery by the pulsing blood under pressure from the heart.
Blood flows throughout the circulatory system because of pressure changes. It moves from an area of high pressure to an area of low pressure.

Front 2

Systolic pressure?

Back 2

The peak of maximum pressure when ejection occurs .

Front 3

Diastolic pressure?

Back 3

When the ventricles relax, the blood remaining in the arteries exerts a minimum pressure. It is the minimal pressure exerted against the arterial walls at all times.

Front 4

Pulse pressure?

Back 4

The difference between systolic and diastolic pressure.

Front 5

What indicators does the blood pressure reflect?

Back 5

Cardiac output, peripheral vascular resitance, blood volume, blood viscosity, and artery elasticity.

Front 6

Caridac output?

Back 6

Blood pressure depends on the cardiac output.
When volume increases in an enclosed space, such as a blood vessel, the pressure in that space rises.
Thus, as cardiac output increases, more blood is pumped against arterial walls, causing the blood pressure to rise. Cardiac output increases as a result of an increase in heart rate, greater heart muscle contracility or an increase in blood volume.

Front 7

Peripheral resistance?

Back 7

Blood circulates through a network of arteries, arterioles, capillaries, venules and veins. Arteries and arterioles are surrounded by smooth muscle that contracts or relxes to change the size of the lumen. The size of arteries and arterioles changes to adjust blood flow to the needs of local tissues.

Front 8

Blood volume?

Back 8

The volume of blood circulating within the vascular system affects blood pressure. If volume increases, this exerts more pressure against arterial walls. When volume falls, blood pressure falls (dehydration, hemorrhage)

Front 9

Viscosity?

Back 9

The thickness of blood affects the ease with which blood flows through small vessels. The hematocrit, or percentage of red blood cells in the blood, determines blood viscosity. When the hematocrit rises and blood flow slows, arterial blood pressure increases. The heart contracts more forcefully to move the viscous blood through the circulatory system.

Front 10

Elasticity?

Back 10

Normally the walls of an artery are elastic and easily distensible. As pressure within the arteries increases, the diameter of vessel walls increases to accommodate the pressure change.
Arterial distensibility prevents wide fluctuations in blood pressure. However, in certain diseases, such as arteriosclerosis, the vessel walls lost their elasticity and are replaced by fibrous tissue that connot stretch well. With reduced elasticity there is greater resistance to blood flow.As a result, when the left ventricle ejects its stroke volume, the vessels no longer yield to pressure. Instead, a given volume of blood is forced through the rigid arterial walls, and the systemic pressure rises. Systolic pressure is more significantly elevated than diastolic pressure as a result of reduced arterial elasticity.

Front 11

Factors influencing blood pressure?

Back 11

Age - an adult's BP tends to rise with advancing age.
Stress - anxiety, fear, pain and emotional stress increases heart rate, cardiac output and vascular resistance.
Daily variation - lowest during sleep.
Medications - opioid analgesics lower blood pressure. Vasoconstrictors and an excess volume of IV fluids increase BP.
Activity and weight - a period of activity can reduce blood pressure for several hours afterrwards. Increase in oxygen demand during activity increases BP.
Weight gain and obesity cause hypERtension.
Smoking - results in vasoconstriction. BP rises when a person smokes and returns to baseline in about 15 minutes after.

Front 12

Blood pressure classifications?

Back 12

Normal - less than 120/80
Prehypertension - 120-139/80-89
Stage 1 hypertension - 140-159/90-99
Stage 2 hypertension - more or equal to 160/100

Front 13

Hypertension?

Back 13

Diastolic readings greater than 90 mm Hg and systolic readings greater than 140 mm Hg.
One elevated BP measurement does not qualify as a diagnosis of hypertension.
Associated with the thickening and loss of elasticity in the arterial walls.The heart continually pumps againnst greater resistance. As a result, blood flow to vital organs decreases.
Major factor underlying deaths from strokes and is a contributing factor to heart attacks.
You can control hypERtension but can't cure it.

Front 14

Prehypertension?

Back 14

Diagnosed in adults when an average of two or more diastolic readings on at least two subsequent visits is between 80 and 89 mm Hg or mose subsequent visits is between 120 and 139 mm Hg.

Front 15

HypOtension?

Back 15

Present wehn the systolic pressure falls to 90 mm Hg or below.
Occurs because of the dilation of the arteries in the vascular bed, the loss of a sunstantial amount of blood volume or the failure of the heart muscle to pump adequately.
Hypotension associated with PALLOR, SKIN MOTTING, CLAMMINESS, CONFUSION, INCREASED HEART RATE, OR DECREASED URINE OURPUT is life threatening and is reported to a health care provider IMMEDIATELY.

Front 16

Orthostatic hypOtension or postual hypOtension?

Back 16

Occures when a nomotensive person develops symptoms and low blood pressure when rising to an upright position.
When recording orthostatic BP measurement, record the client's position in addition to the BP measurement: 140/80 Hg sitting. DO NOT DELEGATE this procedure.

Front 17

Medications and BP?

Back 17

Diuretics - lower blood pressure by reducing reabsorption of sodium and water by the kidneys, thus lowering circulating fluid volume.
Beta-adrenergic blockers - reduce heart rate and cardiac output.
Vasodilators - cause relaxation and reduce peripheral vascular resistance.
Calcium channel blockers - reduce peripheral vascular resistance by sytemic vasodilation.
ACE inhibitors - lower blood pressure by blocking the conversion of angiotensin I to angiotensin II, preventing vasoconstriction, lowering circulating fluid volume.
Angiotensin-II receptor blockers (ARBs) - lowers the blood pressure by blocking the binding of angiotensin II, which prevents vasoconstriction.

Front 18

Measurement of blood pressure?

Back 18

Arterial blood pressure measurements are obtained either
directly (invasively) - requires the insertion of a thin cathter into an artery. Used in intensive care oniy only. or indirectly (noninvasively) - auscultation or palpation with auscultation is the most widely used technique.

Front 19

What to look for when taking BP?

Back 19

Encourage client to avoid caffeine and smoking before BP assessment (caffeine (3 hours) or nicotine (15 minutes)causes BP elevations).
Have client rest at least 5 minutes before measuring client BP sitting or lying down; wait 1 minute if client standing. When possible, have client sit in the chair.
Ask client not to speak.
Position client's forearm at heart level.

Front 20

How to position the blood pressure cuff?

Back 20

Position cuff 2.5 cm (1 inch) above site of pulsation.

Front 21

Auscultation?

Back 21

Listening for sounds within the body, especially from the chest, neck or abdomen. A stethoscope is typically used.

Front 22

What to keep in mind?

Back 22

During the initial assessment obtain and record the blood pressure in both arms.
Pressure difference greater than 10 mm Hg indicate vascular problems and are reported.
Note the arm used to measure the blood pressure (RA - right arm).

Front 23

Ultrasonic stethoscope?

Back 23

Allows you to hear low-frequency systolic sounds.
Used frequently on children, infants and low blood pressure in adults.

Front 24

Palpation?

Back 24

Examination by application of the hands or fingers to the external surface of the body to detect evidence of disease or abnormalties in the internal organs.
Useful for clients whose arterial pulsations are too weak - severe blood loss and decreased heart contractility.
When using the palpation, record the systolic value and how you measured it (RA 90/-, palpated, supine).

Front 25

Lower extremity blood pressure?

Back 25

the politeal artery, palpate behind the knee in the popliteal space, is the site for auscultation.
Place the client in a prone position. If not possible, ask the client to flex the knee.
Position the cuff 3.5 cm (1 inch) above the popliteal artery.
Systolic pressure in the legs is usually 10 to 40 mm Hg higher but diastolic is the same.

Front 26

Doppler?

Back 26

The use of ultrasound technology to determine blood flow velocity in different locations in the heart, but esp. across the heart valves.
Used to get an accurate reading on pulse rate of an older adult or obese client.