The nurse is assessing the blood pressure of a client. The nurse obtains the blood pressure in both of the client's arms

Question

The nurse determines that there is a difference of 15 mmHg in the systolic readings between the arms and repeats the assessment with the same results. Based on this data, which does the nurse suspect?
1. Inaccurate technique.
2. Anxiety.
3. Unilateral arterial obstruction.
4. Shock.

Answer 1

Correct Answer: 3
A difference of readings 10 mmHg or more between arms may indicate an obstruction of arterial blood flow to one arm and is considered an abnormal finding. After repeating the procedure and determining the results were the same, the nurse would not necessarily assume that the technique was faulty. Client anxiety may result in a higher blood pressure reading. It would not result in a difference between blood pressures assessed in each arm. If the client is developing clinical manifestations associated with shock, the nurse would most likely determine that the client's blood pressure is lower than normal. Shock would not result in a difference between blood pressures assessed in each arm.