MEDizzy - A nurse takes a client’s blood pressure with an automatic

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Safety and Infection Control

A nurse takes a client’s blood pressure with an automatic blood pressure machine. The blood pressure is 86/56 mm Hg with a pulse rate of 64 beats per minute. Which action should the nurse do first?

ExplanationInitially, the nurse should assess the condition of the client and ascer- tain if there are physical signs consistent with hypotension resulting in decreased perfusion to the brain and peripheral circulation. After as- sessing the client’s condition, the nurse should recheck the blood pressure to verify the accuracy of the reading. The nurse should not elevate the head of the client’s bed since this action would further lower the blood pressure. Determining the normal range of blood pressure is indicated after condi- tion assessment and verification of the reading.