How to Accurately Take Manual Blood Pressure (Nursing Students)

If you’re new to nursing school, taking manual blood pressure can feel intimidating at first but don’t worry! This guide breaks down the process into simple, easy-to-follow steps so you can learn how to do it the right way. I’m six months into nursing school, and I remember how terrified I was to take manual blood pressure, especially during my first skills check-off. You’ll learn how to use your stethoscope and cuff, where to listen for the pulse, and how to record accurate readings. By the end, you’ll feel confident performing one of the most essential nursing skills.

1) Manual Blood pressure cuff

2) Stethoscope

3) A chair and Table for proper positioning

4) Alcohol wipes (to clean the stethoscope)

5) Pen and paper (to record vitals)

6) A partner or blood pressure practice arm

1) Wash your hands thoroughly with soap and water or use hand sanitizer if hands aren't visibily soilled

2) Use an alcohol wipe to clean the earpieces and Diaphragm of your stethoscope

3) make sure the blood pressure cuff is not twisted and that the Gauge (manometer) needle points to zero when it's at rest

4) Check that the air valve on the inflation bulb opens and closes smoothly

(Remember that clean equipment prevents the spread of germs and ensures accurate readings)

1) Ask your partner to sit down in a chair with feet flat on the floor, and legs uncrossed

(Remeber that if your patient is crossing their legs their blood pressure can rise up to 10 units more)

2) Their arm should red comfortably on a table, palm facing up, and be at heart level

3) Make sure their upper arm is bare (remove any tight sleeve, or roll it up)

4) Instruct them to remain still and silent during the procedure since movement and talking can affect accuracy

1) Feel for the brachial pulse - it's located on the inside of the upper arm, just above the crease of the elbow

2) Use the pads of your index and middle fingers, not your thumb, to feel for the pulse since your thumb has its own pulse

3) Once you find it, mentally note or mark the location - that's where you will place the stethoscope later

(If you have toruble finding the brachial pulse, lightly press and move your fingers around until you feel a rhythmic pulsing)

1) Wrap the cuff evenly around the upper arm, about 1inch above the elbow crease

2) Make sure the artery marker printed on the bucc lines up with the brachial artery you just found

3) The cuff should be snug but not too tight - you should be able to slide two fingers under the cuff comfortably

4) Ensure that the tubing is not twisted and that tir runs down the center of the arm

(f the cuff is too loose or too tight, your readings will be inaccurate)

1) Place the earpieces of your stethoscope in your ears with the tips pointing slightly forward (toward your nose)

2) Place the diaphragm (the flat circular part) of the stethoscope directly over the brachial artery - just below the cuff edge

3) Hold it gently in place using your fingertips (never press too hard- it can distort the sounds)

(Avoid letting the tubing touch the cuff of your clothes, as rubbing noises can make it harder to hear the pulse)

1) Locate the air valve on the inflatio bulb and turn it clockwise to close it (do not overtighten)

2) Using your other hand, feel the radial pulse at the wrist

3) Inflate the cuff by squeezing the bulb until the radial pulse disappears, then add 20 mmHg

4) This is your predetermined (estimated) systolic pressure

5) Slowly deflate the cuff completly and wait 60 seconds before moving on

(This technique tells you roughly where the systolic pressure will be which is your top number of the BP number as well as prevents unnecessary overinflation and ensuring our patients comfort)

1) With the stethoscope still in place, re-inflate the cuff to 20 mmHg above the predetermined systolic you just found

2) Make sure the valve is closed before inflating

3) Stop pumping when you reach the number on the gauge (for example, if your estimated systolic was 120, inflate to 150)

1) Open the valve slowly so the cuff deflates at the rate of 2-3 mmHg per second

2) As the pressure drops, listen through your stethoscope for loud pulses

(The FIRST clear sound is your Systolic)

(The LAST sound before silence is your Diastolic)

3) Record both number right away (118/76)

(One imporant things to now is that it goes by 2's so you will NEVER have an odd number)

1) Open the valve completely and release all the air untill the gauge returns to zero

2) Remove the cuff gently

3) Thank your patient for their cooperation and tell them their BP, but explain whether it is high or low (educate them)

1) Write down the Systolic/diastolic reading, the arm used, the position, and the time

(Right arm, sitting - 118/76 mmHg at 15:36)

1) Wipe the stethoscope earpieces and diaphragm with alcohol wipes again

2) Wipe the cuff tubing and bulb