Hypertension is a common condition affecting about 18% of the population and is a major risk factor for heart disease and stroke.
- Arm rest
- Height measure
- Venepuncture set
- Knowledge of the aetiology of hypertension and associated risk factors.
- To record an accurate blood pressure measurement.
- To screen for associated risk factors and discuss importance of healthy lifestyle.
- To interpret readings and arrange follow up or referral.
- Welcome and check identity of patient
- Check source of referral
- Seat and reassure
- Explain procedure and answer questions, obtain consent.
- Relax patient
- Apply appropriate sized cuff with tubes running down the antecubital. The bladder within the cuff should have a width of about 40% of the circumference of the arm (12-14cm average). The length of the bladder should be about 80% of this circumference (almost long enough to encircle the arm).
- Support forearm and elbow at level of heart.
- If no previous guiding measurements check systolic pressure using radial pulse. Otherwise, pump up pressure steadily, then slowly release while listening with stethoscope over brachial artery (3-4 mm Hg per second).
- Record phase 1 (systolic) and phase 5 - total fade out (diastolic).
- Repeat on other arm on at least one occasion, if BP raised repeat readings on at least 2 more occasions.
- Weight and height - BMI (discuss)
- Urinalysis for protein and sugar
- Lifestyle: smoking; diet; exercise; alcohol; salt (discuss)
- Family history: I.H.D.; hypertension; diabetes Cont.
- Blood tests: FBC; glucose; U&Es; lipids; urate.
- Arrange follow or referral.
- Update computer
- Aneroid instruments need regular recalibration.
- A Guide to Blood Pressure Classification in Adults
- Bates, B (1995) A Guide to Physical Examination and History Taking 6th Ed. J.B. Lippincott, Philadelphia.
- Chapman, J (1999) Treatment of Hypertension. Practice Nursing Vol 10 No 17 p29-30
- Cowley, N (1999) What is Hypertension? Practice Nursing Vol 10 No 17 p 25-28