# N6 · Blood Pressure at the Chair

A useful pressure report combines measurement quality, symptoms, and the pattern between treatments.

![Infographic: N6 · Blood Pressure at the Chair](https://urinenephrology.org/visual-reference/images/nursing-n06.png?v=20261003c)

## Rest → repeat → record

Use a correct-sized cuff on the non-access arm, supported posture, and rest when feasible. Repeat an unexpected value while assessing symptoms. Record the actual repeated pressure, pulse, position, timing, and medicines taken.

## Separate urgency from trend

Chest pain, severe dyspnea, neurologic deficit, confusion, or poor perfusion with abnormal pressure needs urgent assessment. An asymptomatic high reading still needs confirmation and follow-up, with timing based on clinical context.

## Track the dialysis pattern

Record the lowest SBP each treatment. A rise >10 mmHg from pre- to postdialysis into the hypertensive range in at least 4 of 6 sessions is a review signal. Pair it with weights, removal, symptoms, medication timing, and home BP.

## Bring readings from home

Home or ambulatory measurements can add information that chair readings miss. Confirm device technique, dates, symptoms, and the clinician’s individualized goals; avoid applying one universal dialysis blood-pressure target.

## Keep medication decisions clear

Reconcile the actual antihypertensive schedule and recent hospital changes. Do not independently add doses, hold all medicines, or raise ultrafiltration solely because a predialysis measurement is high.

## Ask for a written action plan

Give repeated readings, symptoms, home log, recent weights, and treatment tolerance. Confirm the patient’s call thresholds and medication schedule. A high chair reading alone does not authorize extra antihypertensive medicine or faster fluid removal.

## Supporting evidence

- [Supporting guideline or source](https://pmc.ncbi.nlm.nih.gov/articles/PMC7215236/)

## Source lessons

- [N6 Blood Pressure at the Chair](https://urinenephrology.org/mastery/maintenance-hd/nursing/N6-Blood-Pressure-at-the-Chair.html)

Read alongside the full lessons; the findings and decisions shown here require the stated clinical context.