Blood Pressure

blood pressure (BP) Etymology: AS, blod + L, premere, to press the pressure exerted by the circulating volume of blood on the walls of the arteries and veins and on the chambers of the heart. Blood pressure is regulated by the homeostatic mechanisms of the body by the volume of the blood, the lumen of the arteries and arterioles, and the force of cardiac contraction. In the aorta and large arteries of a healthy young adult, blood pressure is approximately 120 mm Hg during systole and 70 mm Hg during diastole. See also hypertension, hypotension. method The indirect blood pressure is most often measured by auscultation, using an aneroid or mercury sphygmomanometer, a stethoscope, and a blood pressure cuff. With the upper arm at the level of the heart, the cuff is placed around the upper arm and inflated to a pressure greater than the systolic pressure, occluding the brachial artery. The diaphragm of the stethoscope is placed over the artery in the antecubital space, and the pressure in the cuff is slowly released. No sound is heard until the cuff pressure falls below the systolic pressure in the artery; at that point a pulse is heard. As the cuff pressure continues to fall slowly, the pulse continues, first becoming louder, then dull and muffled. These sounds, called sounds of Korotkoff are produced by turbulence of the blood flowing through a vessel that is partially occluded as the arterial pressure falls to the low pressure of diastole. When the cuff pressure is less than the diastolic pressure, no pulse is heard. Thus the cuff pressure at which the first sound is heard is the systolic blood pressure, indicative of the pressure in the large arteries during systole; the cuff pressure at which the sounds stop is the diastolic blood pressure, indicative of the pressure in the arteries during diastole. A variation of this method involves the use of palpation in place of auscultation in the antecubital space to determine the systolic pressure (the pressure at which a pulse is first palpated). Another variation uses a transducer in the cuff to translate changes in ultrasound frequency caused by blood movement within the artery to audible sounds. Blood pressure may be monitored directly by means of a strain gauge or mercury manometer after a cannula has been placed in an artery. The flush method is used when blood pressure is difficult to measure by other methods. The cuff is applied, and complete capillary emptying is performed, usually with an elastic bandage. The cuff is inflated, the elastic bandage is removed, and the earliest discernible flush is observed as the cuff is deflated. This method measures mean blood pressure. interventions The intervals at which the patient's blood pressure is to be taken are specified. The pressure in both arms is taken the first time the procedure is performed; persistent major differences between the two readings is indicative of a vascular occlusion. Alternatively, the blood pressure may be taken using the thigh and the popliteal space when the leg is at the level of the heart. The width of the cuff should be one third to one half the circumference of the limb used. Thus, a larger cuff is required for a large patient or for any patient if the pressure is taken at the thigh. outcome criteria Any factor that increases peripheral resistance or cardiac output increases the blood pressure. Therefore, it is important to obtain a blood pressure reading when the patient is at rest. Increased peripheral resistance usually increases the diastolic pressure, and increased cardiac output tends to increase the systolic pressure. Blood pressure increases with age, primarily as a result of the decreased distensibility of the veins. As a person grows older, an increase in systolic pressure precedes an increase in diastolic pressure. Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier

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Blood Pressure Pressure is exerted by the blood on the walls of the blood vessels and mainly arteries. Blood pressure is measured on the radial artery by using a sphygmomanometer (inflatable rubber cuff that is applied to the arm and connected to a graduated scale, enabling the determination of blood pressure by increasing and releasing the pressure in the cuff), stethoscope, and blood pressure cuff.

It is measured in millimeters of mercury either as a fraction with the numerator being the maximum pressure (systolic) that the heart pumps blood into the left ventricle of the heart. The denominator being the minimum pressure (diastolic) that the heart pumps blood or as a whole number that represents the first value only.

Procedures ◦To begin taking the patient’s blood pressure, use a blood pressure cuff. The length of the cuff's bladder should be at least equal to about 80% of the circumference of the upper arm. ◦Wrap the cuff around the upper arm with the cuff's lower edge one inch above the antecubital fossa. ◦Gently press the stethoscope over the brachial artery below the cuff's edge. ◦Rapidly inflate the cuff to 180mmHg. Release air from the cuff at a moderate rate which is about 3mm/sec. ◦ Use the stethoscope to listen as you observe the sphygmomanometer. The first knocking sound is the patient’s systolic pressure. When the knocking sound disappears, that is the diastolic pressure. ◦Record the pressure in both arms and take note of the differences

Changes made to Blood Pressure definition

The original medical definition included an overwhelming about of information that included words I was not familiar with. In order to simplify the definition and make it easier to understand, I had to summarize the medical definition and include only the important bits of information and simple procedures. I noticed while reading the medical definition that all of the words were bunched together. There was no separation between the different procedures and detailed explanations regarding blood pressure. This made it harder to follow along with and comprehend the correct way to take someone’s blood pressure. In my definition, I made sure to separate the definition from the proper procedures. For the procedures I broke it down to six bulletin points so that it would be quicker and easier to identify the steps. Also, to make it easier to understand, I included a picture of a diagram that has instructions on how to take someone’s blood pressure step by step. As far as sentence structure goes, I tried to use only simple and compound sentences in my definition. The medical definition used words and descriptions that are not commonly used by people who are not in or familiar with the medical field and its extensive terminology. To fix this problem I printed off a copy of the medical definition, read through it, and highlighted all of the important pieces that stuck out to me. Then I went back over the context and used a thesaurus to find a more common word to replace the confusing medical terms that were given. If for some reason I could not find a word that could be simplified, like sphygmomanometer, I made sure to include the definition following the word. By doing this I hope that the audience will be able to understand my definition of blood pressure better and be able to follow the procedures of efficiently. For example, instead of saying “The indirect blood pressure is most often measured by auscultation, using an aneroid or mercury sphygmomanometer, a stethoscope, and a blood pressure cuff,” I wrote, “Blood pressure is measured on the radial artery by using a sphygmomanometer, stethoscope, and blood pressure cuff.” I hope that the changes I made in order to write my definition will help the audience understand what blood pressure is and the procedures to take it more clearly than the medical definition. By sticking to two types of sentence structures, more common medical terms, illustrative examples, and a list of simplified procedures these should help the reader have a better understanding and be able to apply their new knowledge if a situation ever requires it.