The goal of this exercise is to help you learn how to improve a set of instructions by applying the advice provided in Chapter 23.

The Exercise

The following instructions describe how to determine blood pressure in humans. While these instructions are fairly well written, they could be improved in a number of ways by more closely following the guidelines in Chapter 23.

You may download the Revision Checklist for Instructions for use with this exercise.

1. Read the instructions and indicate places where headings might help the reader.
2. Look for any steps that contain too much information and mark them. Should substeps be included here? Should another step be added?
3. Locate steps that might be clearer were they accompanied by an illustration.

Determining Blood Pressure

1. If you are right-handed, slip the pressure cuff over your left upper arm and extend your arm, palm facing upward.
2. Place your arm on a table so that it rests at the same level as your heart.
3. Turn the cuff so that the stethoscope diaphragm is on the inside of the arm.
4. Find the pulse with your index and middle fingers on the inside of the arm near the elbow. Now place the stethoscope diaphragm on top of it.
5. Wrap the cuff and secure it.
6. Hold your manometer (gauge) in your left hand for reading.
7. Close the air-flow valve on the inflating bulb by turning the knob clockwise.
8. Inflate the cuff by repeatedly squeezing the bulb with your right hand.
9. Listen to the pulse beat while inflating the cuff.
10. When you can no longer hear the pulse beats raise the pressure an additional 30 mmHg.
11. Slowly open the air-flow valve by turning it counterclockwise so that the pressure drops about 2-4 mmHg with each beat of your heart.
12. After opening the air-flow valve, listen carefully for a pulse beat.
13. The moment your hear the faint rhythmic thumping sounds of the pulse beat, note the reading on the gauge. This is your systolic blood pressure.
14. Allow the pressure to continue dropping at the same rate as before.
15. Listen carefully with the stethoscope for swishing sounds.
16. When you can no longer hear the sounds, read the gauge and record it. This is your diastolic pressure.