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Transcript: The pressure blood in circulation exhert on blood vessels Generally, the pressure in a person's upper arm Measured at the brachial artery (major blood vessel carrying blood away from the heart) Auscultatory Method How does this measure blood pressure? BP= Luckily, high blood pressure can be controlled... The pressure at which the rushing sound (fifth Korotkoff sound) stops is the diastolic pressure. Auscultatory Method (most common) These two pressures are used to measure blood pressure in mmHg such that: But this can vary by age... systolic pressure Dangerous Levels: A normal BP reading is 120 mmHg/80 mmHg Having high blood pressure (hypertension) can cause various health problems: When BP is a risk factor: measured by... The pressure at which the rushing noise (first Korotkoff sound) is heard is the systolic pressure. Blood Pressure Age Race Family History Obesity Smoking Not being active Drinking too much alcohol Uses a stethoscope and sphygmomanometer Fit a cuff around the person's upper arm Inflate manually until no sound is heard through the stethoscope Slowly release pressure until a pounding noise (first Korotkoff sound) is heard Release pressure further until the noise stops (fifth Korotkoff sound) Coronary heart disease Heart failure Kidney failure Stroke Lose weight Exercise regularly Eat healthy foods Reduce sodium intake Limit alcohol consumption Don't smoke Cut back on caffine Reduce stress diastolic pressure
Transcript: Blood Pressure Objectives Understand the anatomy & physiology behind blood pressure & cardiac cycle Differentiate systolic and diastolic blood pressure values Develop a systematic approach to the patient Know the blood pressure classifications Why is Blood pressure important? Incidence: 77.9 Millions Americans (1 out of every 3) Incidence: Male > Female before 45 Male = Female 45-64 Female > Male after 65 HTN is 2-3 more likely in women on OCP African americans with HTN have increasing prevalence for last 15 years. They develop early in life and have greater death rates About 69% of people who have a first heart attack, 77% who have a first stroke, and 74% who have congestive heart failure have blood pressure higher than 140/90 mm Hg. Death from HTN are rising Estimated 7.2% increase of HTN nationwide by 2030 reference: American Heart Association (2013). 2013 Update on Hypertension Estimated direct and indirect cost associated with HTN... $ 51,000,000,000. (AHA, 2009) (yes, thats billions) Risk factors Risk factors: genetic, gender, ethnicity, weight, lower education and socioeconomic class, lower phys activity, psychosocial stressors, dietary. Persistant high blood pressure can lead to: CVA, TIA, AMI, hypertensive cardiomyopathy, hypertensive nephropathy, elevated blood glucose, hypertensive retinopathy, hypertensive encephalopathy. What is blood pressure? At its basic, it is the pressure of blood against the walls of the arteries. Pressure is affected by 2 factors 1. Contractility of heart 2. Resistance of blood vessels 120/80 = Systolic/diastolic The higher (systolic) number represents the pressure while the heart contracts to pump blood to the body. The lower (diastolic) number represents the pressure when the heart relaxes between beats. Other factors that influence BP: volume, viscosity. PULSE PRESSURE is the difference in the systolic and diastolic pressure. Sphygmomanometer Choose the right size cuff Support patient’s arm Korotkoff sounds over brachial artery Stepwise approach Find a quiet room Remove extra clothing from site Locate the brachial pulse Center cuff bladder over brachial artery (2.5 cm above antecubital space) (use arrows on cuff) Secure cuff snugly with patients arm slightly flexed Hold patient’s arm or secure on a flat surface Palpate radial pulse then inflate (+30mmHg is the maximum) - deflate* Wait 30 seconds before re-inflating* Place stethoscope over brachial pulse Inflate to your target and deflate slowly, auscultating the sounds * - optional Record the number of the first sound heard (systolic) Record the number of the last sound heard. (diastolic) BP Guidelines: Normal <120/ <80 Prehypertension 120-139 or 80-89 Stage I HTN 140-159 or 90-99 Stage II HTN >160 or >100 Information contained in this lecture from: Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7 Express)
Transcript: References http://www.diffen.com/difference/Systolic_vs_Diastolic_Blood_Pressure Stress What is Blood Pressure? Blood Pressure is the measurement of pressure of the blood flowing through your blood vessels (called arteries) against the vessel walls. Blood pressure tends to change with age dramatically. Hence it is very crucial that you check your blood pressure regularly. http://www.medindia.net/patients/calculators/bp_chartresult1.asp Increased consumption of alcoholic beverages can raise blood pressure dramatically Exercise and Good Nutrition For Your Health Systolic vs Diastolic Smoking Systolic Pressure: peak pressure in the arteries, which occurs near the end of the cardiac cycle when the ventricles are contracting Diastolic Pressure: minimum pressure in the arteries, which occurs near the beginning of the cardiac cycle when the ventricles are filled with blood Injures the blood vessel walls and speeds up the process of hardening of the arteries. Blood Pressure and You What affects your Blood Pressure? Alcohol Can help lower blood pressure Hypertension, also referred to as high blood pressure, is a condition in which the arteries have persistently elevated blood pressure. The ideal blood pressure for a young adult is 120/80. You can have a minimum of 108/73 and a maximum of 132/83 to still be considered in a healthy range. Level of Severity Systolic Blood Pressure Diastolic Blood Pressure Mild Hypertension 140-160 90-100 Moderate Hypertension 160-200 100-120 Severe Hypertension Above 200 Above 120 Chronic stress raises blood pressure
Transcript: Right ventricle Blood Pressure: Right ventricle Pressors Volume increase Blood Pressure Pressors CVP Left ventricle PCWP “ A warning sign that can identify preventable outcome for Clients.” CVP Volume removal Lead to prevent harm. Caring patients = critical thinking. In R.A. Day, P. Paul, B. Williams, S.C. Smeltzer, & B. Bare. Brunner & Suddarth’s textbook of Canadian medical-surgical nursing. (1st ed.). (pp. 1174-1176). Philadelphia: Lippincott Williams & Wilkins. l pulmonary Left ventricle PCWP Consider the Client Controlling Blood pressure Objectives pulmonary Ayan Dalel Mack, RN, MSN Dilators Volume removal Volume increase Consider the Client Why Blood pressure? Strategies in controlling Blood pressure. Blood pressure and patient illness. Goal: To identify blood pressure regulation needed for individual patients with different needs . Blood pressure is like a chess game systemic To identify blood pressure regulation needed for individual patients with different needs . Controlling Blood pressure MAP MAP Dilators systemic
Transcript: WHAT IS BLOOD PRESSURE? The pressure on the arteries when the heart is at rest SYSTOLIC PRESSURE BLOOD PRESSURE Sytolic BP is the when the heart muscle is contracting or when the heart is pumping. Diastolic BP is when the heart musle relaxes or when the heart rest. SYSTOLIC/DIASTOLIC Pronounced : 'sfig mo man ometer' Blood Pressure is the amount of pressure excerted on the inside walls of the blood vessels DIASTOLIC PRESSURE The amount of force needed to pump blood out of the heart into the peripheral circulation SPHYMOMANOMETER The instrument used to measure BP Average NORMAL ADULT BLOOD PRESSURE 120/80
Transcript: Blood Pressure Kristen Wilks What is blood pressure? Can hypertension affect children? How and why? The person will start to get: headaches dizziness nausea, nose bleeds visual changes. Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure. A blood pressure cuff is a device used to measure the force of the blood in the veins and arteries. At rest, the force of blood flow is constant and, in healthy individuals, ranges between 110/70 and 120/80. The larger number is the systolic number--the force of blood as the heart contracts. The lower number is the diastolic number--the force of blood as the heart relaxes. If the force of the blood is greater than 120/80, this may indicate hypertension. A blood pressure cuff is specially calibrated to register the force of the blood and help medical personnel determine the patient's health status. The patient can also monitor his own blood pressure with the use of a home monitor. Each sound defined Yes, it can affect children. Obesity is the main cause for this. Obesity is caused from too much food and little activity. Does diet and salt play a part in hypertension? Steps taken to obtain a blood pressure. How does a blood pressure cuff work? Is there more than one cuff size and if so why? age race family history obesity not being physically active the use of tobacco too much salt (sodium) in your diet too little potassium in your diet too little vitamin D in your diet drinking too much alcohol stress certain chronic conditions There is more then one cuff size, which is according to the patient. If the wrong cuff size is used, it can obtain an inaccurate reading for the blood pressure. The two types of cuff are called manual and automatic. The work similarly. The normal ranges for blood pressure are 60 - 90 mm Hg Facts Its cause the arteries and veins to constrict Increases the circulating blood volume Hypertension - high blood pressure 140/90 Hypotension - low blood pressure 90/60 How does a person's kidney affect blood pressure? What does the letters mmg indicate? make sure you have the right cuff size clothing does not constrict arm and blood flow the cuff is in the right position and application gauge should be at heart level with palm of hand up place stethoscope over the brachial artery at the antecubital space ear pieces should be pointed forward tubing not tangled cuff should be placed in the center of the upper arm and 1' space above the antecubital area of the arm control the valve do not over inflate cuff What sounds are heard and why? How does a person know if their blood pressure is high? These letters indicate the milligrams the measurement of pressure of blood that is exerted on the walls of arteries during various stages of heart activity What are the normal ranges for blood pressure readings? Factors that can contribute to high blood pressure.
Transcript: The Slightly Disturbing History of Taking Blood Pressure BP = CO x SVR BP = (5.3 L/min)(900 dynes sec/cm5) BP = Sources an EXAMPLE PROBLEM Blood Pressure our math book www.ehow.com www.wikipedia.org www.scottishintensivecare.org www.thefreedictionary.com apbrwww5.apsu.edu SVR CO A nurse is calculating a patient's blood pressure. The patient's cardiac output is 5.3 L per min and the systemic vascular resistance is 900 dynes · sec/cm5. Determine the patient's blood pressure in mm Hg. Average adult male: 5.6 L per min Average adult female: 4.9 L per min We use this formula to calculate blood pressure: BP = CO x SVR BP is blood pressure CO is cardiovascular output SVR is systemic vascular resistance the MATH Thank heavens. Cardiac output is the volume of blood that your heart's ventricles pump out in one minute. "The first measurements of blood pressure were made in the early eighteenth century by Stephen Hales, an English botanist, physiologist, and clergyman. He found that pressure from a horse's heart filled a vertical glass tube with the horse's blood to a height of 8 feet 3 inches. He accomplished this by inserting a narrow brass pipe directly into an artery and fitting a 9-foot-long vertical glass to the pipe. Fortunately, today a much safer, more convenient, and simplified method for measuring blood pressure is available everywhere." This abbreviation refers to the resistance that arteries, capillaries, and veins in the body present to blood flow
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