Question

Helen, a 25-year-old, visited her doctor to have a routine physical examination for a life

insurance policy. She had no history of previous illness and was fit and well.

Physical Examination

On examination, the nurse found Helen had a blood pressure in the upper arm of 140

mmHg systolic, 95 mmHg diastolic. This was repeated two more times with similar

results. On questioning, Helen said she had a very busy morning and had to rush to get to

the Doctor's. As it was, she arrived 15 minutes late for her appointment.

Further Investigation

It was arranged that Helen would return another day to spend about 30 minutes lying

down and relaxing before her blood pressure was taken. On this occasion, the nurse found

that Helen's blood pressure in the upper arm was 125 mmHg systolic, 85 mmHg diastolic.

A) What do you think about the first blood pressure measurements Helen had would they be considered abnormal for a 25-year-old woman?

B) What do you think about the measured blood pressure on Helen’s second visit? Explain why it was lower than on her first visit

C) What important lessons from Helen’s experience can you learn about measuring blood pressure?

Answer 1

A)Stress activates the sympathetic nervous system,triggering the release of adrenaline and cortisol.These hormones prepares the body for "fight or flight response" by making the heart to beat faster and constricting the blood vessels to get more blood to the core of the body instead of extremities.

Constriction of blood vessels and increase in heart rate raises the blood pressure, but only temporarily.When stress reaction goes away blood pressure returns to its pre-stress level.

So, according to the scenario given the stress experienced by Ms.Helen might the reason to have increased blood pressure.

B)The body's stress response system is usually self limiting.Once the stress have relieved hormone levels return to normal.As adrenaline and cortisol level drop,the heart rate and blood pressure returns to baseline level.

In case of Helen's 1st visit she was under tension about her appointment which will stimulate stress response.This will result in increased blood pressure and on another day she made to get relaxed for a while.Relief of stress makes the hormone levels to come back to its baseline level.So, the blood pressure also maintained within normal limits.

C)Usually certain instructions should be followed before checking the blood pressure.Blood pressure generally raises due to stress, smoking,exercise,caffeine,certain drugs.so any of the factors that may increase the blood pressure should be avoided.

According to this scenario we have to check the factors for the increase of blood pressure and make the client to relax for a while if stress is the reason and if they have taken any caffeine,tobacco check the blood pressure after 30 minutes.