Download Apical Pulse

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The number of heart beats per minute
It is the rhythmic expansion and contraction
of the arteries which are measured to indicate
how fast the heart beats per minute.
Each expansion and contraction is measured
as one pulse beat.
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We feel a pulse
where the artery
crosses over a bone
near the skin
surface.
Pulse is an easy,
painless way to
measure the
circulatory function.
http://www.smart-heart-living.com/images/pulse-wrist.jpg
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Bradycardia –
slow pulse for the patients age and condition
Tachycardia –
fast pulse for the patients age and condition
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Arrythmia –
irregular heart beat
http://www.smartnow.com/content/ecg.jpg
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Radial Pulse –
pulse located at the
base of the thumb
and wrist.
http://i.ehow.com/images/a04/rs/7r/normal-pulse-rate-men-800X800.jpg
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Apical Pulsepulse located at the
apex (bottom tip) of
the heart.
http://static.howstuffworks.com/gif/sound-of-heartbeat3.jpg
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Before birth…
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140 – 160 bpm
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At birth…
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130 – 140 bpm
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First year of life…
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115 – 130 bpm
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Childhood years…
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80 – 115 bpm
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Adult years…
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50 – 80 bpm
Palpate – to feel with fingered hand
We feel (palpate) for 3 qualities:
1. Rate – the number of beats per minute
a. 30 seconds x 2 = bpm
b. Rate is described as:
* Normal
* Fast (Tachycardia)
* Slow (Bradycardia)
2. Rhythm – regularity of the heart beat
Rhythm is described as:
* Regular, steady
* Irregular, skipped beats
* Extra beats
* Cyclic irregularity
*** If irregular pulse noted you need to take an apical
pulse for 60 seconds ( one full minute).
3. Force – strength of heart beat
Force is described as:
* Average, normal
* Weak, thready
* Strong, Bounding
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Exercise
Age
Emotional
excitement
Hemorrhage
Fever
Drugs
http://www.soc.ucsb.edu/sexinfo/images/05-08-exercise.jpg
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Drugs
http://newzar.files.wordpress.com/2009/01/prescription-drugs.jpg
Apical pulse –
always done for 1
full minute with a
stethoscope.
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* Infants / toddlers
*Radial pulse is
irregular
* Tachycardia
(>100 bpm)
Physicals
Pre-op
* Always done for
these reasons!
http://i.ehow.com/images/a05/f6/4i/listen-baby_s-heartbeat-800X800.jpg
 Use
the diaphragm
of the stethoscope
 Place
the
diaphragm on the
left side of the
patients chest,
1 – 1 ½ inches
below the nipple
1.
2.
3.
4.
Heart disease
Arterial disease
Anxiety
Weight
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Incorrect technique
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Incorrect location
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Incorrect calculation
A. 30 second method – done for patient with
normal pulse characteristics during radial
pulse method.
B. 60 second or 1 minute method1. Patient whose radial pulse has any
variation in the normal characteristics
2. All apical pulse measurements
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Tachycardia
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Irregular rhythm
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Weak force
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Rate – any pulse outside of the normal range
for age of the patient
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Rhythm – any irregularity noted
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Force – any pulse that is weak or bounding
A.
B.
Equipment:
1. Watch with second hand
2. Patient assignment sheet
3. Pen or Pencil
Procedure:
1. Wash hands
2. Identify the patient by checking the ID band
3. Tell the patient what you will be doing
4. Have the patient assume a comfortable
position.
5. Support the
patients’ hand and
arm
6. Find the patients’
radial pulse by
placing the tips of
your index and
middle fingers on the
inner surface of the
patients’ wrist at the
base of his/her
thumb
http://www.acefitness.org/calculators/images/radial-pulse.jpg
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CAUTION: DO NOT
use your thumb – it
has it’s own pulse.
You may be
counting your own
pulse instead of the
patients.
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Press lightly so you
feel the pulsation.
CAUTION: by
pressing TOO
HARD, you may
obliterate the pulse
and will NOT be
able to feel it!
http://www.medtrng.com/Fm21_11/21110004.gif
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Feeling the pulse, notice the rate, rhythm and
force
Look at the position of the 2nd hand of your
watch.
Start to count the pulse beats (what you are
feeling) until the 2nd hand reaches 30 second
or 1 minute mark.
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Variations will make
it necessary for you
to extend the
counting method
from 30 seconds to
1 full minute.
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Examples of
variations are:
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Fast rate
Slow rate
Irregular rhythm
Extra beats
Skipping beats
Weak force
Bounding force
A.
Equipment
1. Stethoscope
2. Antiseptic Wipes
3. Watch with a 2nd hand
4. Patient assignment sheet
5. Pen or pencil
B.
Procedure
1. Wash hands
2. Identify the patient by checking the ID band
3. Explain to the patient what you are doing
4. Clean the stethoscope earplugs and diaphragm with
the antiseptic wipes
5. Warm the diaphragm by holding it tightly for a few
seconds
6. Uncover the left side of the patients chest
Caution: Avoid overexposing the patient.
7. Place the
diaphragm over the
apex of the heart.
8.Put the earplugs
in your ears.
9. Listen for the
heart sounds,
noting all three
characteristics.
http://todaysseniorsnetwork.com/Elderly%20Woman%20in%20Hospital%20Bed.jp
10. Count the heart
sounds for 1 full
minute.
11. Record the
findings on your
patient assignment
sheet.
12. Cover and make
the patient
comfortable
13.
14.
15.
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18.
Lower the bed to a position of safety
Raise the side-rails if indicated
Place the call light within easy reach of the
patient
Clean the earplugs and diaphragm with the
antiseptic wipes
Replace the equipment
Wash your hands
19. Report the apical
pulse rate and any
variations of
rhythm and force
20. Record the pulse
on the TPR sheet