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Blood pressure measurement _30187

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Blood pressure measurement _30187 Powered By Docstoc
					?Hypertension, obesity, drugs, blood pressure measurement,




?Blood pressure measurement

?

The patient should at least be quietly in the back of a Chair to sit
for 5 minutes (instead of seeing the table), take off your sleeve,
the upper arm is placed and the heart level. Measuring 30 minutes ago
and do not smoke or not eating food containing caffeine. Each patient
should be informed of the specific oral and written in blood pressure
and blood pressure goal value.

Correct blood pressure measurement there needs to be appropriate for
the size of the upper arm cuffs. Right arm measuring consistency, and
comparability of standard forms. Determine the appropriate size cuff
for dunnage bag width approximately olecranon and acromion measured
in points out of 40% of the upper arm circumference. Cuff size
problems in children (see guideline 13) and obesity in adults is
particularly important with the increasing incidence of obesity, many
adults need large cuff. On the upper arm is cone-shaped, perimeter >
41cm should in forearm blood pressure measurement. The first
affiliated hospital of Soochow University renal medicine Chai huaqi

Too small of dunnage bag can cause high blood pressure reading error
3.2/3.4 ~ 12/8mmHg, obesity can be as high as 30mmHg. Excessive
dunnage bag will cause error low reading 10 ~ 30mmHg. Cuffs of
dunnage bag should at least be around 80% of the arm circumference.

Stethoscope chest pieces should be placed in the light of the
proximal ulna Wo to Central beating over the brachial artery, which
is below the bottom edge of the cuff (that is, in the lair on 2cm
ulna.

Cuffs should be inflated to perceptual of SBP (systolic blood
pressure (more than 2 30mmHg to ~ 3mmHg/s speed. Systolic and
diastolic blood pressure should be logged. First heard the voice of
the blood pressure is the systolic pressure, the sound disappears
(fifth stage) for diastolic blood pressure in adults. Recommends that
a detailed record of the initial treatment of high blood pressure,
body position, select the use of arms, blood pressure, blood pressure,
upper limbs and the circumference of the cuff, auscultation method
(Korotkoff method) of the fourth and the fifth issue of blood
pressure (on behalf of auscultation differences), the patient's
emotional state and medication time .

The interval to 2 minutes of 2 or more times the measurement readings
as average. If the first two times greater than the difference
between the readings of 5mmHg, readings and averaged.

Such as blood pressure must once again confirmed medical measurements
to hypertension. High levels of blood pressure measurement will be
reduced in the future, because:

1 adjustment function (that is, once again seek to reduce anxiety); 2,
the average return, some derived from mathematical factors of non-
biological phenomena. Blood pressure level is not the same as in
standard rest State will also change. A more accurate blood pressure
level is within a few weeks to few months repeated measurements of
the average.

Especially the elderly and children, systolic blood pressure is
greater than the diastolic pressure of end-stage organ failure events
(coronary heart disease, CVD, heart failure, stroke, kidney failure,
and all causes of death). In recent years have been very clear pulse
pressure (systolic, diastolic pressure yajian on behalf of the great
arteries of vascular compliance), is better than separate SBP or DBP
better predict cardiovascular risk factors. Measurement of vascular
compliance of new non-invasive techniques for validating, CKD
patients in the early evidence hints exist to reduce vascular
compliance.

In exceptional circumstances, in the supine position, posture, and
standard (quiet stand 2 ~ 5 minutes) you can prompt and help diagnose
autonomic regulation of dysfunction. Orthostatic changes > SBP 10mmHg
Vertigo or pale common in elderly patients with systolic hypertension,
diabetes, and the use of diuretics, vasodilator (nitrates, α
receptor antagonist and sildenafil-like drugs) and certain acts on
psychotropic substances. The same case after taking medication
(peripheral adrenergic receptor blockers, α-receptor antagonist,
high-dose diuretics) blood pressure with the postures too violent
patients. In these cases suitable for measurement of ABMP (automatic
blood pressure monitoring).
Blood pressure measurement in elderly patients need special attention.
According to the measurement of blood pressure and pulse beat,
because of the vascular stiffness, some older people have a false
hypertension (high blood pressure meter readings to false). Moreover,
the elderly hypertensive patients, especially women, there might be a
white-coat hypertension and systolic blood pressure. In the absence
of target organ damage, a doctor should consider false hypertension
or white-coat hypertension. In this case ABPM is very useful.

Sphygmomanometer preferred sphygmomanometer. Proven electronic
instrumentation and calibration of liquid blood can also be used.



Keywords:
?Hypertension, obesity, drugs, blood pressure measurement,

				
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