Answer Happy

Unrelated Effective 3. rushed getting to the office. 4. has been speaking before the temperature is measure 18. Your patient is a 75-year-old female with early stage Alzheimer disease who was admitted this afternoon to the assisted living facility where you are employed. You are completing the admission paperwork You are measuring her blood pressure for the initial assessment. The expectation is that vital signs are accurately obtained and documented. fective (appropriate or helpful steps), ineffective (inappropriate or potentially harmful steps), or unrelated (will be Directions: For each nursing intervention, use an X to indicate whether the interventions are predicted to be ef- neither harmful nor helpful). Ineffective Nursing Intervention Have the patient rest for 5 minutes before starting the measurement. Ask the patient what her usual blood pressure reading is. Support the arm above the level of the heart. Position the manometer gauge so it can be seen at eye level from a distance of 3-5 feet. Place the cuff and stethoscope directly on the skin. Inflate the cuff while palpating the artery and note where the pulse disappears. Deflate the cuff; wait 10 seconds before reinflating Inflate the cuff 50 mm Hg above where the pulse dis- appeared on palpation Allow the cuff to deflate at 5 mm Hg per second. When the audible sounds disappear while you are deflating quickly reinflate to double-check the last au- dible sound Document the blood pressure per agency policy