To avoid recording an erroneously low systolic blood pressure because of failure to recognize an auscultatory gap, nurse Jackie should:
- A- have the client lie down while taking his blood pressure.
- B- inflate the cuff to at least 200 mm Hg.
- C- take blood pressure readings in both arms.
- D- inflate the cuff at least another 30 mm Hg after the radial pulse becomes unpalpable.
The most appropriate option to avoid recording an erroneously low systolic blood pressure due to a missed auscultatory gap is:
D. Inflate the cuff at least another 30 mm Hg after the radial pulse becomes unpalpable.
Here's why:
A. Have the client lie down while taking his blood pressure:
While lying down can sometimes help hear Korotkoff sounds better, it's not specifically related to recognizing an auscultatory gap.
B. Inflate the cuff to at least 200 mm Hg:
This is unnecessarily high and could cause discomfort for the client. Additionally, it wouldn't guarantee encountering the auscultatory gap in all cases.
C. Take blood pressure readings in both arms:
While this is a good practice for general blood pressure monitoring, it wouldn't directly address the issue of missing the auscultatory gap.
D. Inflate the cuff at least another 30 mm Hg after the radial pulse becomes unpalpable:
This is the recommended technique for detecting the auscultatory gap. The radial pulse disappears when the pressure in the cuff is above the systolic pressure. Inflating an additional 30 mm Hg ensures you're beyond the systolic pressure and into the range where the auscultatory gap might occur. This way, you're more likely to hear the first Korotkoff sounds when they appear, preventing an erroneously low systolic reading.
Therefore, D is the most effective choice for nurse Jackie to avoid missing the auscultatory gap and recording an inaccurate blood pressure.
Remember, it's always important to follow proper blood pressure measurement techniques and adapt them based on the client's individual needs and potential risk factors for auscultatory gaps.
