In the next section of our CNA Skill Set Test Study Guide, we will be covering the procedures for the process of measuring blood pressure. Although many of us are familiar of this step and have probably performed this step multiple times a day, you must remember that the testing requirements don’t always coincide with the practical requirements.
The most dangerous skill sets to demonstrate during the CNA practical test are the ones that we do on a daily routine. We start to form a habit and in the end might miss a step or two. Sure, with your “new” habit, you can still get a good blood pressure measurement, however, certain steps might be overlooked and cause a poor grade or failure. Think of it like your drivers test. After years of driving, if you were to take the test now, thanks to a bad habit you developed, you might not pass that test even though you are a better driver than when you were 16 and passed it the first time.
It is for this reason, that you must take steps like measuring blood pressure very seriously. Therefore, make sure you review the steps below, practice going through them correctly so as to ensure you don’t forget a step or two. No practical factor is less important than another, so take it seriously and methodically and you will be fine.
IMPORTANT: In most states, it is required that your measurement be extremely accurate. Most people fail this because they missed a beat or two and didn’t think anything of it. If you are in question, be sure to tell the proctor the situation and that you are doing it again for a better more accurate reading.
Remember, like all of our procedures, you should always start by entering the room, announcing that you are there and that you will be doing the procedure. Then wash your hands and verify that the room is prepped.
Measuring Blood Pressure Steps
- First, ensure that the patient has no reason for an elevated heart rate such as being worked up, or just completing a strenuous activity. If they have, then wait at least five minutes before continuing.
- Ensure that the resident is in a comfortable position and placed in a position that allows you to get an adequate reading such as supine or sitting.
- Ensure that you have the appropriately sized cuff or also known as a sphygmomanometer. You should have a cuff that covers 40-45% of the upper arm.
- Find the artery located at the bend of the elbow called the brachial artery.
- Wrap the cuff around the upper portion of the arm at least 2 inches from the bend of the elbow.
- Ensure to rest the arm approximately at the height of the heart. If it is below or above, you will have an erroneous measurement due to the difference in pressure.
- Adjust the dial so that you can see the measurements.
- Position the stethoscope over the brachial artery and ensure it is firmly held there.
- Make sure the valve to the cuff pump has been closed otherwise your pumping will not produce pressure.
- Pump the cuff to approximately 30 mmHg above the systolic pressure.
- While holding the stethoscope to the brachial artery, release pressure to the cuff at a rate of about 2-3 mmHg per second.
- Using the stethoscope, mark the point on the gauge when you hear the first beat.
- Continue to release pressure in the cuff until you can no longer hear the sound through the stethoscope. Mark this point.
- Continue listening as the gage passes through 10 to 20 mmHG and beyond the last point of sound. Allow the cuff to completely deflate and remove the cuff from the patient.
- Place the patient back in a comfortable position.
Ensure that you never measure blood pressure in an arm that has been affected by a malady and especially in an arm that has had a mastectomy or has a dialysis shunt.
Video Exercise to Help you Visualize and Practice this Section
Another wonderful video created by the group “4YourCNA.” Again the nurse will show you each of the steps located above (with some different nuances) and will show you the appropriate way to perform this task when doing your CNA test.