During manual BP measurement, which AP action requires follow up?

• A. The AP uses a cuff width that is 40% of the circumference of the client's arm.
• B. The AP provides support for the client's arm during BP measurement.
• C. The AP waits to take the client's BP 45 minutes after ambulating in the hallway.
• D. The AP loosens the valve to reduce pressure within the bladder cuff at a rate of 5 mm Hg per second.

Answer: (D)

Accurate manual BP relies on deflating the cuff at a slow, controlled rate so you can clearly hear the Korotkoff sounds and record the correct pressures. The standard deflation rate is about 2-3 mm Hg per second. Deflating at 5 mm Hg per second is too rapid and makes it easy to miss the onset of the first sound or the point where sound disappears, which leads to inaccurate systolic and diastolic readings. That action needs follow-up and correction. The other practices—using a cuff width about 40% of the arm circumference and supporting the arm at heart level—are appropriate and support accurate measurement. Resting before measurement is important, but the key issue in this scenario is the deflation rate.