**********Peripheral Vascular Resistance PVR or peripheral vascular resistance is how elastic are my vessels. If the vessels are really stretchy the blood pressure is low and if the blood vessels are stiff the blood pressure is high.
Every institution you go to has different equipment and each unit has unique technology that you will be introduced to.
We do manual blood pressures in the nursing home and use an automatic blood pressure machine in the hospitals.
Pulse and respiration are on the state test however, blood pressure is not on the state test as far as taking someone's blood pressure. You will have to know which blood pressure is the hypertensive one and which one is the hypotensive one.
********Systolic blood pressure
When you take a blood pressure the first pressure that you will hear is the systolic pressure. Systolic is considered to be the highest pressure. In order to prevent miscuffing in taking the blood pressure you will measure the elbow to the shoulder and if the cuff fits 2/3 of the arm you have a good fit.
If it is too small of a blood pressure cuff then you have a falsely elevated blood pressure. You need to wait two minutes to get the readings from three inches from the crook of the arm. If you have too large of a blood pressure cuff then you get a lower blood pressure.
If you are taking the blood pressure of a heavyset individual then you need a larger cuff to get a correct blood pressure.
*************What affects blood pressure?
If the person is dehydrated then the blood is thick. The length of the blood vessel affects blood pressure. The diameter of the blood vessel affects blood pressure. The position you take the blood pressure in affects the blood pressure.
Homones and enzymes affect blood pressure too. Vasoconstriction effects on peripheral blood pressures increases blood pressure. Epinephrine and norepinephrine increase blood pressure by constricting the veins and both are vasoconstrictors. Vasoconstrictors increase your blood pressure.
Aldosterone is from the adrenal cortex. Renin is from the kidneys. Angiotensisn is activated by the renin response.
************On taking a blood pressure
If you take a blood pressure more than once then wait 1-2 minutes.
The blood pressure of a person is lower when standing up.
The blood pressure for acutely ill patients you should wait at least two hours in between blood pressures.
The factors affecting blood pressure is a change in position.
You can get a falsely high reading if the cup is too small or too loose or if the client supports his or her own arm.
For a rapid deflation you let the air out.
Blood pressure increases when a person exercises, or there is pain, emotion and caffeine.
Blood pressure decreases when a person is sleeping, and there is very fast or slow irregular heart rates because the heart can't fill and the blood pressure is lower.
***********Normal leg blood pressures
Normal leg systolic is higher than arm blood pressure. Diastolic blood pressure should be equal to or lower than the arm blood pressure but if you start taking it on the arm then keep taking it in the arm and if you start taking blood pressure in the legs then keep taking it in the legs.
Abnormally low leg blood pressure occurs with aortic insufficiency. If the patient's blood pressure increases then they are hypertensive.
Primary hypertension has no identifiable cause and 90% of people have this. HTN or hypertension is anything that is high for you.
Normal systolic is less than 120 and normal diastolic is less than 80.
So Stage 1 HBP high blood pressure is 120-130 systolic and 80-89 diastolic.
High blood pressure can be controlled with diet and exercise.
************Things that increase HTN or hypertension in hospitalized patients
Things that increase HTN in hospitalized patients are: pain, stress/emotions, lack of exercise, change in diet, medications, increased IV fluids or blood, disease process, and circadian rhythms which controls the sleep patterns.
Cardiac status changes in the elderly include blood pressure drops. The blood pressure should always take the person's age into account. The pulse changes can be related to hypoxia airway problems.
The nurse palps the blood pressure not me the certified nursing assistant.
A difference of over 10mm Hg between arms suggest something is going on and there is arterial compression on the side of the lower reading.
When you have aortic dissection that means that the person is close to death it may also be due to a coarctation of the aorta.
“The aorta is the body's main artery. It distributes oxygen-rich blood to all parts of the body except the lungs. The first branches of the aorta go to the upper body (arms and head). After that, blood goes to the lower body (abdomen and legs).
Coarctation of the aorta is a narrowing of the aorta between the upper-body artery branches and the branches to the lower body.
This blockage can increase blood pressure in your arms and head, reduce pressure in your legs and seriously strain your heart. Aortic valve abnormalities often accompany coarctation.” From http://www.americanheart.org/presenter.jhtml?identifier=11069
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