Lab Report Essay

As part of my module Nip1002 I was required to perform a set of observational skills which included; pulse, blood pressure, respirations, hand washing and urinalysis and then compare them to previous results. In this lab report I am going to discuss blood pressure in detail. Procedure * Explain the procedure to the patient and gain consent * Wash hands thoroughly following the hand wash technique to prevent the transfer of bacteria * Clean equipment e.g. blood pressure cuff and stethoscope using antibacterial wipes * Ensure the patient is comfortable and has been resting for 10 minutes * Remove tight clothing and support the arm at heart level, overestimation or underestimation can occur if it is not at the appropriate level * Ensure you have the correct cuff size for the patient or this could give an inaccurate reading * Locate the brachial artery and apply the cuff * Estimate the systolic pressure by using the radial pulse and inflate the cuff until the pulse cannot be felt. This is important to provide an estimation and avoids error in reading. * To take the patient’s blood pressure use a stethoscope and place on the brachial artery pulse and inflate 20-30 mmHg higher than the estimated systolic pulse * Immediately release the pressure using the thumb valve at approximately 2mmHg per second. If it is deflated too rapidly you may not hear the sounds accurately * The systolic pressure is the level when clear tapping sounds first appear and the diastolic pressure is the level when the sounds disappear * Record the measurements on an observation chart and compare the previous results as this will allow changes in the patient’s condition to be monitored appropriately (see appendix 3) * Remove the cuff and explain the reading to the patient * Clean all equipment and wash hands again to prevent cross infection (Glasper, Richardson; McEwing, 2009, p.168 & 169) Discussion The heart is located in the centre of the chest and is protected by the rib cage. The heart receives oxygenated blood from the lungs through the pulmonary veins. It then goes to the left atrium, to the left ventricle, to the ascending aorta and is pumped around the body. The superior and inferior vena cava delivers de-oxygenated blood to the right atrium from the body. (See appendix 1) It then goes to the right ventricle, pumps through to the pulmonary trunk to the right and left arteries and then to the lungs. (Tortora and Derrickson, 2011, Chapter20) Blood pressure is the force exerted by the blood on the walls of blood vessels and this should be at a certain level to ensure that the body is functioning correctly. Blood pressure varies from person to person but the normal reading for a healthy adult is around 120/80. (BPA 2008) The top number is called systolic blood pressure and is the highest pressure attained in arteries during systole. The bottom number is called diastolic blood pressure and is the lowest arterial pressure attained during diastole. (Tortora and Derrickson, 2011, p.814) The blood pressure reading that I got on my patient was 120/90 this was slightly higher from the previous readings which were 90/50 and 90/60. Although this reading is slightly high I would not consider it to be a case of hypertension. Hypertension is when your blood pressure readings consistently show readings of 140/90 mmHg. (NHS, 2010) A persons chances of having hypertension are raised due to a number of factors; age, weight, family history and diet. Hypertension creates a higher risk of heart attacks and strokes. ((Glasper, Richardson; McEwing, 2009, p.170) Reflection I am going to use Gibbs (Glasper; Richardson, 2011, p.xix) reflective cycle (see appendix 2) to analyse my reflection. I did a set of observations which included; pulse, respirations, blood pressure, hand washing and urinalysis. When I was doing the observations I was very nervous and I was aware that I was being evaluated which made me feel stressed. Overall I think I did well in the exam because I remembered all the steps and got it done in the time limit. I felt I could have done better if I wasn’t as nervous, as I feel this affected my skills technique. Looking back on the exam I think I was lacking in communication skills as I did not talk to the patient enough. In conclusion it is important that all vital signs are monitored as this can be one of the first indications that a patient is deteriorating. Blood pressure is one of the most important physiological measurements used to diagnose a patient’s condition. References BPA (2008) what is normal blood pressure? [online]. BPA. Available from: http://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Whatisnormal [Accessed 27th July 2012] Glasper, A. Mcewing, G. and Richardson, J., (2009). ‘Introduction’ in Glasper, A, Mcewing G, and Richardson., Foundation studies for caring. Palgrave McMillan, pxix Glasper, A. Mcewing, G. and Richardson, J., (2009). ‘skills for physiological assessment’ in Glasper, A, Mcewing G, and Richardson., Foundation skills for caring. Palgrave McMillan, p168 & p169 Glasper, A. Mcewing, G. and Richardson, J., (2009). ‘skills for physiological assessment’ in Glasper, A, Mcewing G, and Richardson., Foundation skills for caring. Palgrave McMillan, p170 NHS (2011) High blood pressure: hypertension. [online]. NHS. Available from: http://www.nhs.uk/conditions/Blood-pressure-(high)/Pages/Introduction.aspx [Accessed 5th of August 2012) Tortora, G, and Derrickson, B,. (2011). ‘The cardiov ascular system: Blood vessels and hemodynamics’. In Tortora, G and Derrickson, B., Principles of Anatomy and Physiology: Maintenance and continuity of the human body’ (13th edit) Wiley. p814. Tortora, G, and Derrickson, B,. (2011). ‘The cardiovascular system: The Heart’. In Tortora, G and Derrickson, B., Principles of Anatomy and Physiology: Maintenance and continuity of the human body’ (13th edit) Wiley. Chapter 20. Appendix 1