blood pressure measurement

wash hands or rub hands
identify client; introduce self to client
explain procedure to client and gain verbal consent
where possible, measure blood pressure under the same conditions each time
allow client to rest several minutes after exercise or smoking before the procedure
expose upper part of client's arm and ensure client is in the desired position
i) lying, sitting or (standing?)
ii) palm of the hand facing upward
iii) sphygmomanometer position at heart level
according to the client's arm, choose an appropriate cuff size
wrap the deflated cuff snugly and smoothly around the upper part of the arm. The bottom of the cuff approximately 3cm above the antecubital space (the depression in front of the elbow) with centre of cuff bladder over brachial artery
to establish a baseline, locate the radial pulse with the fingertips of your non-dominant hand. Inflate the cuff while simultaneously palpating the artery and note the point on the manometer where the radial pulse can no longer be felt (this provides an estimate of the systolic blood pressure)
deflate the cuff completely and wait 1-2 minutes before continuing to measure
locate and palpate the brachial artery with fingertips (medial aspect of antecubital fossa), and place the stethoscope over the brachial artery
inflate the cuff rapidly to a pressure 30 mmHg higher than the estimated systolic blood pressure
deflate the cuff gradually at a rate of 2-3 mmHg per second until the first korotkoff sound (Phase I) is heard
[systolic blood pressure (Phase I sounds): the appearance of faint, clear tapping sounds, which gradually increase in intensity]
read pressure on manometer at eye level
continue to deflate cuff until the sound changed to a muffled sound (Phase IV)
[diastolic blood pressure (Phase IV sounds): when sound changes from a distinct tapping to a muffled sound which becomes soft and blowing]
remove cuff from client's arm
check that client is comfortable
compare blood pressure reading with previous recording
document the assessment data accurately
report any abnormalities to appropriate staff
inform client of reading
clean stethoscope after use
wash hands or rub hands