Page 302 - Saunders Comprehensive Review For NCLEX-RN

stimulation that increases the BP.
c. The incidence of high BP is higher
among African Americans than among
Americans of European descent.
d. Antihypertensive medications and
opioid analgesics can decrease BP.
e. BP is typically lowest in the early
morning, gradually increases during
the day, and peaks in the late
afternoon and evening.
f. After puberty, males tend to have
higher BP than females; after
menopause, women tend to have
higher BP than men of the same age.
g. Additional factors affecting the BP
include smoking, activity, and body
weight.
2. Guidelines for measuring BP
a. Determine the best site for assessment.
b. Avoid applying a cuff to an extremity
into which intravenous (IV) fluids are
infusing, where an arteriovenous shunt
or fistula is present, on the side on
which breast or axillary surgery has
been performed, or on an extremity
that has been traumatized or is
diseased.
c. The leg may be used if the brachial
artery is inaccessible; the cuff is
wrapped around the thigh and the
stethoscope is placed over the popliteal
artery.
d. Ensure that the client has not smoked
or exercised in the 30 minutes before
measurement, because both activities
can yield falsely high readings.
e. Have the client assume a sitting (with
feet flat on floor) or lying position and
then rest for 5 minutes before the
measurement; ask the client not to
speak during the measurement.
f. Ensure that the cuff is fully deflated,
then wrap it evenly and snugly around
the extremity.
g. Ensure that the stethoscope being used
fits the examiner and does not impair
hearing.
h. Document the first Korotkoff sound at

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