In which circumstance is measuring blood pressure in the thigh appropriate over the arm?

• A. A Severe edema in both arms
• B. B The client has a fracture in the arm
• C. C The client is acutely febrile
• D. D The client has a shunt in place for dialysis

Answer: (A)

The key idea is to choose a site that can give an accurate, reliable reading when the usual site is unusable. If both arms have severe edema, you can’t get a clean seal or reliable pressures with an arm cuff, so measuring BP on the thigh becomes the appropriate alternative. Put the cuff on the upper thigh with the patient lying supine, locate the femoral artery for auscultation, and use an appropriately sized cuff. Be aware that thigh readings are generally higher than arm readings and interpret accordingly in the clinical context. Other conditions, like a fracture in one arm, may also limit arm measurements, but the thigh is specifically indicated here because both arms are severely edematous and unsuitable for cuff placement.