Last Updated: November 21, 2020 Compare BP with previous readings and, if there is cause for concern, inform senior nursing or medical colleagues (Royal College of Physicians, 2017; Beevers et al, 2015). Perform the first measurement with the patient lying down, following the procedure described above. A drop in blood pressure (BP) on standing (orthostatic hypotension – OH ) is a common occurrence in acutely unwell hospitalised patients and is a risk factor for falls. Hypotension, or low blood pressure, has a lot of causes but can be normal for you. Something called "orthostatic hypotension" occurs when a person’s blood pressure drops considerably when transitioning positions (going from lying down to sitting up, sitting to standing, etc.) Measure the blood pressure while the patient is in a standing position especially in the event that the patient experiences lightheadedness on standing. Also consider whether the patient’s pulse increases by a normal rate. Compare readings with those taken previously – if there is cause for concern, inform senior nursing or medical colleagues. Your blood pressure will go up and down naturally throughout the day depending on what you are doing, especially if you are doing exercise. Lassiegohome Jul 12, 2008 Have your blood pressure measured twice, with a brief break in between. Write the systolic blood pressure number, a slash, and then the diastolic blood pressure number. After one minute of rest, the blood pressure was subsequently taken supine position. You will recognize the reading for the systolic blood pressure at the moment you begin to hear the "thump" sounds in your stethoscope. When the reading has registered, document the systolic and diastolic BP measurements on the patient’s observation chart, following local protocols. For taking orthistatic blood pressure using a cuff you will have to follow the steps ennuerated above, but also repeat the reading after standing 3 minutes. The American College of Cardiology and the new blood pressure guidelines recommend taking at least 2 to 3 readings, 1 minute apart (r). You might be dehydrated, have low blood sugar, or be taking medication that changes your blood pressure. Place the cuff snugly and neatly onto the patient’s arm, 2cm above the brachial artery, aligning the artery index marker on the cuff with the brachial artery (Fig 3). Wait another 2 minutes, and then take a second set of standing readings. Soon after standing from sitting, blood pressure drops temporary and then increases normally afterwards. Get up for frequent tea/coffee breaks. Check the pulse: if it is irregular, it may be necessary to use a manual BP measurement device. In this case, 93% of readers who voted found the article helpful, earning it our reader-approved status. The routine measurement of both lying and standing BP is recommended in patients aged ≥65 years and those with diabetes or symptoms that suggest they may have postural hypotension; this is because these individuals can experience a significant fall in BP when standing up (NICE, 2019; NICE, 2013). Patients with postural hypotension may feel dizzy and lightheaded so it is important to be alert to this possibility and to ensure that the patient’s safety is maintained. Your blood pressure will go up and down naturally throughout the day depending on what you are doing, especially if you are doing exercise. The exception is when either the patient complains of feeling unsteady when standing up compared with lying down, or when the physician was suspicious of orthostatic hypotension for some other reason, (e.g., Hypotension, or low blood pressure, has a lot of causes but … A record of readings taken over time provides a “time-lapse” picture of your blood pressure that can help you partner with your physician to ensure that your treatments to lower high blood pressure (HBP or hypertension) are working. Finally, after one minute the blood pressure was again taken in this last position with supine position with crossed legs. They will give slightly different readings. (Your left arm should rest comfortably at heart level.) Avoid applying excessive pressure on the diaphragm or tucking the diaphragm under the edge of the cuff, as either of these actions could partially occlude the brachial artery, delaying the occurrence of Korotkoff sounds (Fig 4). One blood pressure measurement is like a snapshot. During the test, you lie on a table that's tilted to raise the upper part of your body, which simulates the movement from horizontal to a standing position. Throughout the procedure, observe and document any signs or symptoms of postural hypotension, including dizziness, lightheadedness, vagueness, pallor, visual disturbance, feelings of weakness and palpitations. Your position during a blood pressure check can influence your readings. At the end of the five-minute period, vitals are measured, including, respirations and blood pressure. A blood pressure test is a simple way of checking if your blood pressure is too high or too low. Measure your blood pressure in both arms when you first start. There’s an excellent article here that goes into more detail on the ins and outs of how sitting affects blood pressure as well as other aspects of your health: The health risks of prolonged sitting. But some people (especially elderly people), sometimes their body is not quick enough to respond this momentary drop — this results in a condition called as ‘postural hypotension’. Just standing is far better for you than sitting and uses more muscles. Blood pressure is measured for a wide range of diagnostic and monitoring purposes. Part 1 of this series discussed the key principles of BP measurement and the types of equipment used; this article describes the procedures for manual and automated measurement, and for lying and standing BP measurement. When you're ready to take your blood pressure, sit quietly for three to five minutes beforehand. Citation: Jevon P (2020) Blood pressure 2: procedures for measuring blood pressure. Always use the same arm. % of people told us that this article helped them. Please help us continue to provide you with our trusted how-to guides and videos for free by whitelisting wikiHow on your ad blocker. A blood pressure test is a simple way of checking if your blood pressure is too high or too low. It should be standing vertical and at your eye level. Helpful videos demonstrating the correct procedure for manual and automated BP measurements are available on the website of the, 100 years: Centenary of the nursing register, 2020: International Year of the Nurse and Midwife, Nursing Times Workforce Summit and Awards, British and Irish Hypertension Society (BIHS), Measurement of Lying and Standing Blood Pressure: A Brief Guide for Clinical Staff, 200729 Blood pressure 2 – procedures for measuring blood pressure, Newly qualified nurses: practical procedures, Don’t miss your latest monthly issue of Nursing Times, Winners of the Nursing Times Workforce Awards 2020 unveiled, Announcing our Student Nursing Times editors for 2020-21, Reducing the cognitive load on nursing staff, Creating an electronic solution for early warning scores, How best to meet the complex needs of people with interstitial lung disease, New blended learning nursing degree offers real flexibility, Final year student nurses remobilised to Covid-19 response, Student nurses in England offered ‘clarity’ on current options, Whistleblower nurse calls for new body to tackle bullying in NHS, Arthritis drugs ‘improve survival and recovery’ of Covid-19 patients, Social care chief nurse urges workforce to take up Covid-19 vaccine, ‘Long-term plan needed’ to address nurses’ Covid-19 trauma, ‘How we are maximising the Covid-19 vaccination offer’, Med student body stresses ‘we do not think we are superior to nurses’ in apology, ‘No evidence’ Covid-19 vaccine will affect fertility, say unions, Research Nurses required to run clinical trials in healthy volunteers, This content is for health professionals only. I have orthostatic hypotension. First, don’t smoke or drink alcohol or coffee within 15 minutes of a blood pressure measurement. Accurate results are essential to ensure patients receive the correct treatment and care in a timely manner. Estimate the systolic pressure: palpate the brachial artery, inflate the cuff and note the reading when the brachial pulse disappears. If the readings are different by 5 points or more, have it done a third time. Other than the last blood pressure … If you measure your blood pressure 2 times a day, this will equal taking your pressure 4-6 times a day in total. You can measure a person's blood pressure in different positions in order to determine whether or not they have orthostatic hypotension. Ideally, a manual BP measurement device should be used. We only sell monitors that are validated by the British and Irish Hypertension Society. 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