Blood pressure is one of the important vital signs. This ppt is for the First year General Nursing and Midwifery (GNM) students to understand the topic with simple language and pictures

1. Mercury was used in the first accurate
pressure gauges and is still used in
medicine today as the standard unit of
measurement for pressure
BLOOD PRESSURE
Ms. Tinu Gloria Mathew
Bsc Nursing

2. Subject:- Nursing Foundations
Unit :- IV
Topic:- Blood Pressure
Class :- GNM
Year :- First yr

3. Introduction
Normal blood pressure is vital to life.
Without the pressure that forces our blood
to flow around the circulatory system, no
oxygen or nutrients would be delivered
through our arteries to the tissues and
organs.
However, blood pressure can become
dangerously high, and it can also get too
low.

4. Definition
Blood Pressure is the force exerted by
the blood against the the walls of the the
blood vessels as it it flows through them.

5. Systolic blood pressure is force exerted
by arterial walls during systole. It is the maximum
pressure during ventricle contraction.
Terminology

6. Diastolic blood pressure is the force exerted
by blood against arterial wall during diastole. It
is the minimum pressure when the ventricles
are relaxed.
Unit of measuring blood pressure is (mmHg)
millimeters of mercury.
Normal blood pressure is 120/80 mmHg.
Pulse pressure is the difference between
systolic and the diastolic pressure.
Normally the pulse pressure is 40mmHg.
Pulse pressure= SBP - DBP = 40 mmHg (Normal)

7. BP = Cardiac output (CO)+ Peripheral
resistance
Cardiac output = Stroke volume x Heart rate.
Blood pressure has very close relationship with:-
cardiac output
peripheral vascular resistance
blood volume
viscosity
elasticity of arterial wall.
Cardiac output is the amount of blood ejected
by heart in one minute.
Stroke volume is the amount of blood ejected by
heart in one cycle.

8. Normally, heart eject 70-80 ml blood in
one cycle.
Cardiac output = Stroke volume x Heart
rate.
If client has 72 heart rate, then cardiac
output is 70x72 ml = 5040ml.

9. Peripheral vascular resistance : Peripheral vascular
resistance (systemic vascular resistance, SVR) is the
resistance in the circulatory system that is used to create
blood pressure, the flow of blood and is also a component
of cardiac function.
When blood vessels constrict (vasoconstriction) this
leads to an increase in SVR. When blood vessels dilate
(vasodilation), this leads to a decrease in SVR.
If referring to resistance within the pulmonary
vasculature, this is called pulmonary vascular resistance
(PVR)..

10. Blood volume: Volume of blood is present in the vascular system. As soon as blood
volume increases, pressure exerted against arterial wall also increases. That is why giving
intravenous fluid in hypotension increases the Blood Pressure. With haemmorhage /
bleeding, blood volume decreases and automatically BP falls.
Viscosity: Viscosity reflects the thickness of Blood. Greater the thickness (viscosity)
blood flows slowly, heart contracts more forcefully,
Elasticity: It is the ability of arterial wall to expand. Greater elasticity, greater ability of
artery to expand its diameter, less resistance, less Blood Pressure.
During disease condition athresclerosis/old age, the elasticity of blood vessel decreases,
wall becomes rigid, resistance to blood flow increases and Blood Pressure increases.

11. Factors Affecting Blood Pressure
1.Age: Blood Pressure varies throughout the
age. As age increases, BP also raises. Older
people, systolic pressure rises with decreased
elasticity.
Body size/obesity : It is observed that as the
body size increases, BP also fluctuates. Heavier
and taller child have higher BP than the smaller
child of same age.
2. Stress and severe emotions:- Anxiety, fear,
pain, stress, sympathetic nervous system get
activated, causing vasoconstriction, increases
heart contraction and ultimately raises Blood
Pressure.
Anxiety → ↑ SNS → ↑Heart rate → ↑Co
→↑Vasoconstriction resistance →↑ BP

12. 3. Gender wise After puberty, male have higher
blood pressure than females. But after
menopause, women tend to have high BP than male of
same age.
4. Ethnicity: African-Americans have higher incidence of
High Blood Pressure than Eurpeon-Americans.
5. Diet: People taking diet rich in salt and unsaturated
fatty acids, have higher Blood Pressure. Cocaine and
Caffeine use increases Blood Pressure.

13. 6. Smoking : raises Blood Pressure. Nicotine
increases BP.
7. Exercise : Regular exercise, decreases the
Blood Pressure. Helps in keeping BP normal.
8. Diurinal variations: Usually, person have low
BP in early morning and gradualy rises and peaks
in evening.
9. Medication : Medications such as opioids,
analgesics and antihypertensive drugs have
greater effect on BP.

14. 10. Chemicals : Such as epinephrine, Antidiuretic hormone (ADH), Angiotensin II causes
vasoconstriction, thus elevating BP. Histamine and bradykinin cause vasodilation, decrease
BP.

16. Articles:-
● Sphygmomanometer
● Stethoscope
● Bowl with alcohol swab
● Paper bag
● Pen and record form

17. Procedure
Collect all articles. Save time and energy
Wash hands Minimizes cross infection
Explain procedure to client i.e. you are going to monitor
Blood Pressure
Enchances cooperation and develops rapport.
Provide comfortable position i.e. is sitting or supine
while keeping upper arm at heart level, palm up.
Avoid false reading if arm is elevated above the
heart level
Ensure that Mercury level of sphygmomanometer is at 0 To have accurate reading

18. Ensure cuff with against client’s arm Prevent false reading
Inappropriate cuff size causes inadequate
compression of artery
Ensure that Mercury meniscus is at your your eye
level.
Ensure accurate reading.
Palpate brachial artery pulse. Locate he artery
Ensure no air in the cuff and wrap it evenly around
the client’s arm centring arrow over branchial atery.
Ensure accurate reading..
Place lower edge of cuff about 1 inch above antique
antecubital fossa.
To ensure brachial site is not covered.
Tuck the the end of wrap under cuff.
Place earpiece of stethoscope in ears and diaphragm
on brachial artery.
Proper placement of stethoscope ensure optimal
sound perception.

19. Close valve of pressure bulb clockwise until tight. Prevents air leakage.
Rapidly inflate cuff to 30 mm Hg above palpated
systolic pressure.
Slowly release the the pressure bulb valve and allow
the Mercury to fall at rate of 2-3 mmHg.
Indicates systolic pressure.
Listen and watch the Mercury level drop.
Sound is heard, note the systolic pressure.
Continue to deflat the bulb and when sound
disappears, note the diastolic pressure.
Indicates diastolic pressure.

20. Listen for 10- 20 mmHg after the last sound and then
escape air quickly.
Remove cuff.
Inform client their BP reading as needed. Give respect to individual.
Record reading immediately. Ensure prompt and accurate documentation.
Replace all the articles. Wash hands. Minimise cross infection.

21. Terms
Hypertension: Elevated systolic pressure or diastolic pressure at least for 5
consecuave
visits. i.e. 140/190mmHg.
Hypotension: BP falls below normal limits of client. Generally, systolic pressure
falls
to 90mmHg or below.
Orthostatic Hypotension/ Postural Hypotension : Suddenly BP fall of
normol-tensive
client while rising to upright position.