Measuring Blood Pressure
Blood pressure measurement monitors cardiovascular health and detects conditions such as hypertension and hypotension.
1Step-by-Step Procedure
- 1
Gather equipment: aneroid or mercury sphygmomanometer, stethoscope, alcohol wipe, pen, paper.
- 2
Clean the stethoscope earpieces and diaphragm with an alcohol wipe.
- 3
Wash hands.
- 4
Identify the resident and explain the procedure.
- 5
Assist the resident to sit or lie comfortably with the arm at heart level, palm up, elbow slightly flexed.
- 6
Ask the resident to sit quietly and not talk during the measurement.
- 7
Expose the upper arm; remove or roll up sleeve — do not constrict by rolling too tightly.
- 8
Palpate the brachial artery on the inner aspect of the antecubital fossa.
- 9
Center the bladder of the cuff over the brachial artery, aligning the artery marker if present.
- 10
Place the lower edge of the cuff 1–2 inches (2–3 cm) above the antecubital fossa.
- 11
Secure the cuff snugly — you should be able to slide two fingers under it.
- 12
Place the stethoscope diaphragm (or bell) over the brachial artery.
- 13
Close the bulb valve and inflate the cuff to approximately 180 mmHg (or 30 mmHg above the estimated systolic pressure).
- 14
Open the valve slowly, deflating at 2–3 mmHg per second.
- 15
Note the pressure at which you first hear a clear Korotkoff sound (systolic).
- 16
Continue deflating and note the pressure at which sounds disappear (diastolic).
- 17
Deflate the cuff completely and remove it.
- 18
Record both readings as systolic/diastolic (e.g., 120/80 mmHg), arm used, and position.
- 19
Wash hands and report abnormal values to the nurse.
What the Examiner Is Watching For
- ✓
Cuff is placed 1–2 inches above the antecubital fossa, centered over the brachial artery.
- ✓
Cuff is snug but not too tight (two-finger rule).
- ✓
Stethoscope is placed over the brachial artery, not under the cuff.
- ✓
Deflation is slow and steady (2–3 mmHg per second).
- ✓
Both systolic and diastolic readings are recorded accurately.
Common Mistakes That Cause Failure
- ⚠
Placing the stethoscope under the cuff rather than below it on the artery.
- ⚠
Deflating too fast — this causes inaccurate readings.
- ⚠
Cuff too loose or too tight — use the two-finger rule.
- ⚠
Not cleaning the stethoscope before use.
- ⚠
Failing to record the arm used and the resident's position.
Tips for Exam Day
- →
Clean the stethoscope first — it is part of the evaluated procedure.
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The lower edge of the cuff is 1–2 inches ABOVE the elbow crease.
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Deflate slowly and steadily; rushing causes you to miss the sounds.
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Normal adult BP is approximately 90–120 mmHg systolic and 60–80 mmHg diastolic; know the ranges.
Also study the written exam topics
Physical Care Skills makes up 45% of the written exam — the same procedures you just reviewed will appear as multiple-choice questions.
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