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Evidenced Based Practice on Blood Pressure in Arm Vs. Forearm

Evidenced Based Practice on Blood Pressure in Arm Vs. Forearm. Sarah Kneaskern , Andrew Nottleman , Laura Phillips. Appropriate BP Cuff Size . Proper sized blood pressure cuffs are important for accurate readings. BP cuff that is too small causes false high BP reading.

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Evidenced Based Practice on Blood Pressure in Arm Vs. Forearm

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  1. Evidenced Based Practice on Blood Pressure in Arm Vs. Forearm Sarah Kneaskern, Andrew Nottleman, Laura Phillips

  2. Appropriate BP Cuff Size • Proper sized blood pressure cuffs are important for accurate readings. • BP cuff that is too small causes false high BP reading. • BP cuff that is too big causes false low BP reading. • Width of the cuff is 40% of the circumference of midpoint of the limb being used. • The bladder of the cuff should encircle at least 80% of the upper arm.

  3. Positioning for BP Measurement • While obtaining BP make sure the arm is at heart level. • In sitting position, support and raise the arm to heart level. • While supine, may use a pillow to prop the arm at heart level. • Taking a BP in an unsupported arm can increase systolic BP up to 10 mm/hg. • Crossing the legs while obtaining BP can also increase BP, so keep legs uncrossed.

  4. Inadequate BP Readings

  5. Forearm BP Indications • BP measurements in the upper arms may be contraindicated due to IVs, fistulas, casts, mastectomies, or obesity. In this case the forearm may be used for blood pressures. • Position the appropriate size cuff midway between the elbow and the wrist with the artery marker at the radial artery. • The forearm and upper arm BP reading are not interchangeable. If you use the forearm to obtain BP, you must DOCUMENT this information.

  6. Forearm BP • BP may vary 5-10 mm/Hg between extremities this is considered normal (this is why an average is recorded for the initial visit). • BP cuff size and circumference of the arm is a proportional relationship but do not use the same BP cuff on both sites. • Forearm BP results in a 10-30 mm/Hg increase in BP Vs. an upper arm BP.

  7. References Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., et al, & Camera, I. M. C. (2011). Medical- Surgical Nursing, assessment and management of clinical problems. (8th ed.). St. Louis, Missouri: Mosby. Ogedegbe, G., Pickering, T. (2010, Nov) Principles and Techniques of Blood Pressure Measurement. NIH Public Access Author Manuscript, 28(4): 571-568. Doi: 10.1016/j.ccl. 2010.07.006. Potter, P. A., Perry, A. G., Stockert, P. A., Hall, A. M. (2012). Fundamentals of Nursing. (8th ed.). St. Louis, Missouri: Mosby. Trottier, D., & Kochar, M. (1992). Around-the-clock blood pressure monitoring: how to get good results. Nursing, 22(11), 66.

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