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Introduction: In hypertensive patients M position (sitting, right arm at the level of heart and both plantar surface of foots on the floor) is the standard position for measurment of blood pressure since it reveals the “true” pressure. Materials and

Methods: It is a quaziexperimental study that compares effect of different positions of limbs on blood pressure of hypertensive patients. The sample size was consisted of 100 hypertensive patients. A questionnaire and a check list for systolic and diastolic blood pressure of the patients in different positions were used. One researcher collected all of the data. At first demographic data, weight and hight were recorded. After 5 minutes in sitting position in 3 different comparing positions, M (sitting, right arm at the level of heart and both plantar surface of foots on the floor), A (sitting, right arm hanging beside the body and both plantar surface of foots on the floor) and B (sitting, right arm hanging beside the body and right foot on the left knee), blood pressure was measured and recorded. The study methods included interview and physiologic measurement. The paired t-test for related measure was applied in order to analyse the data.

Results: The results showed that the difference of mean systolic and diastolic blood pressure in “A & M”, “B & M” and “B & A” positions was significant (paired t test, p<0.0001) and the mean of systolic and diastolic blood pressure in “A” position was more than “M” position, “B” position was more than “M” position and “B” position was more than “A” position.

Conclusion: According to the findings of this study, “B” position has the greatest effect and “M” position has the lowest effect on increasing the systolic and diastolic blood pressure. This research indicated that attention to the limbs position during the measurement of blood pressure is very important.

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Background & Aim: Intradialytic hypotension is the most frequent complication in patients receiving haemodialysis (HD). This complication not only contributes to the illness of the patients, but also decreases the efficacy of the HD. So, hypotension prevention is a major challenge for medical team, especially for nurses. One of the preventive methods that have recently been presented is the use of sodium profile and ultra filtration (UF) profile. The aim of this study was to compare the effects of linear sodium + UF profile (type1) with stepwise sodium + UF profile (type3) on systolic and diastolic blood pressure in HD patients.

Methods & Materials: In this crossover design study, 26 HD patients from two dialysis centers at Esfahan University underwent three kinds of treatment: (1) control, constant dialysate sodium concentration of 138 mmol/L with constant UF (2) linear sodium profile + UF profile (type1), a linearly decreasing dialysate sodium concentration (146-138mmol/L) in combination with a linearly decreasing UF rate and (3) stepwise sodium profile + UF profile (type2), a stepwise decreasing dialysate sodium concentration (146-138 mmol/L) in combination with a stepwise decreasing UF rate. Each treatment was applied in three dialysis sessions. Data were analyzed using repeated measure ANOVA test in the SPSS.

Results: Twenty six patients participated in the study. A total of 234 dialysis sessions were analyzed. There were no significant differences in the systolic blood pressure between three groups during predialysis and first and the second hours (P>0.05). The mean of systolic blood pressures were higher in the third hour and postdialysis during two types of profiles (1&3) compared with the routine care group (P<0.05). The mean of diastolic blood pressure was also higher in postdialysis during two types of profiles (1&3) compared with the routine group (P<0.05). There was no significant difference between the profiles 1and 3 (P>0.05).

Conclusion: In conclusion, sodium profile + UF profile is a simple and cost-effective method that modulate the dialysate sodium and ultra filtration rate and preserve the homodynamic status and blood pressure of patients during dialysis. Therefore, using sodium profile + UF profile (type1 & type3) is recommended in order to prevent hypotension and reduce nursing work during hemodialysis process.

 

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Background & Objective: Labor potentially causes stress and anxiety, especially in nulliparous women. In Iran, many pregnant women undergo cesarean section electively due to fear of labor pain. The purpose of this study was to investigate the effect of reflexology on the anxiety level, blood pressure, and pulse in nulliparous women in Kerman.
Methods & Materials: In this clinical trial, 70 nulliparous women with gestational age more than 37 weeks and cervical dilatation of 3-4 cm were recruited for the study. The participants were randomly allocated to two equal reflexology and control groups. The reflexology group received the intervention for 20 minutes (each foot: 10 minutes) on their feet and the control group received massage for 20 minutes on their legs. Anxiety level, blood pressure and pulse rate were measured at baseline and immediately after the intervention using Spielberger questionnaire.
Results: Anxiety level did not differ between the two groups at baseline (P=0.85). After the intervention, the mean of anxiety level was significantly lower in the reflexology group than in the control one (P<0.001). The pulse rate (P=0.44) and blood pressure (P=0.59) did not differ significantly in two study groups after the intervention.
Conclusion: Reflexology reduced anxiety level in labor.

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  Background & Aim: Vascular events and strokes are third leading causes of death worldwide. There are also major causes of human morbidity. Various pharmacological and non-pharmacological treatments are proposed to patients with stroke. The purpose of this study was to determine effect of foot reflexology, as a non-pharmacological procedure, on systolic and diastolic blood pressures in patients with stroke.

  Methods & Materials: In this clinical trial, 68 patients with stroke were selected and divided randomly into two experiment (n=34) and control (n=34) groups. Each patient in the experiment group received foot reflexology for 30 minutes. Data were recorded in the demographic and blood pressure record form. Data were analyzed using t-tests and ANOVAs in the SPSS-20. 

  Results: There were no significant differences between the mean systolic and diastolic blood pressures of patients in experiment and control groups at baseline. The blood pressure was significantly reduced among the experiment group after receiving the foot reflexology (P<0.05). The mean systolic blood pressure was significantly reduced in the experiment group after 10 and 30 minutes of massage and the diastolic blood pressure was reduced significantly in all measured times (P<0.05).

  Conclusion: Results showed positive effects of foot reflexology on reducing blood pressure in patients with stroke. Foot reflexology should be recommended as a supplement treatment in patients with stroke.

  

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Background & Aim: Sedation after coronary artery bypass graft surgery can prevent the side effects of the treatment. The purpose of this study was to determine the effect of controlled sedation based on the Richmond scale on the duration of mechanical ventilation and the changes of blood pressure in patients following coronary artery bypass graft surgery.
Methods & Materials: In a single blind randomized clinical trial (IRCT2017050517693N2) from June to August 2017, a convenience sample of 80 patients after coronary artery bypass graft surgery, hospitalized in the intensive care unit of Heshamat Center, Rasht, were selected and randomly allocated into two groups (each group=40). Sedative drug dose was determined using the Richmond agitation sedation scale in the intervention group and determined routinely (based on hemodynamic changes) in the control group. Pain as a confounding variable was evaluated using CPOT tool. Data were analyzed by descriptive statistics and Chi-square, Mann-Whitney, independent t-test and repeated measures ANOVA using the SPSS software version 22.
Results: The mean age of samples was 59.89±7.53 and 66.7% of them were male. There was a significant difference between two groups in the duration of mechanical ventilation (P<0.04), the changes of patients’ blood pressure (P<0.05), need for a vasopressor drug (P<0.05) until extubation and need for the first administration of sedatives (P<0.001).
Conclusion: Utilizing the Richmond tool can reduce the patient’s dependence on ventilator and changes in arterial pressure. Also, using this tool can prevent unnecessary and early administration of sedative and vasopressor drugs in patients.