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Pulse Pulse • Definition- the pressure of the blood felt against the wall of an artery as the heart contracts and relaxes, or beats • Felt in arteries that lie fairly close to the skin and can be pressed against a bone by the fingers Pulse – Pulse sites • Temporal – at side of forehead • Carotid – at neck • Brachial – at inner aspect of forearm at antecubital space • Radial – at inner aspect of wrist above thumb; most common site • Femoral – at inner aspect of upper thigh • Popliteal – behind knee • Dorsalis pedis – at top foot arch Pulse – Measured in number of beats per minute • Rate – number of beats per minute • Rhythm – regularity; regular or irregular • Volume – strength; strong, weak, thready, or bounding Pulse – Pulse rates vary depending on age, sex, and body size • Adults – 60 – 90 bpm – Men – 60 – 70 bpm – Women – 65 – 80 bpm • Children over 7 years – 70 – 90 bpm • Children 1 to 7 years – 80 – 100 bpm • Infants – 100 – 160 bpm Pulse –Bradycardia – pulse under 60 bpm –Tachycardia – pulse over 100 bpm –Arrhythmia – irregular or abnormal rhythm Pulse • Factors that may change pulse rate – Increased – exercise, stimulant drugs, excitement, fever, shock, and nervous tension – Decreased – sleep, depressant drugs, heart disease, coma, and physical training • Document findings - P Apical Pulse • Definition– pulse count taken at the apex of the heart with a stethoscope – Stethoscope amplifies the actual heart beat – Usually ordered on patients with irregular heartbeats, hardening of the arteries, or weak or rapid radial pulses, and infants – Two separate heart sounds are heard while listening to the heartbeat = “lubb-dupp” caused by closing of heart valves as blood flows through chambers of the heart – Each lubb-dupp counts as ONE heartbeat Apical Pulse – Pulse deficit – heart condition in which heart is weak and does not pump enough to blood to produce a pulse or heart beats too fast and there is not enough time for the heart to fill with blood • The heart does not produce a pulse during each beat • Apical pulse rate is higher than the pulse rate at the other pulse sites on the body • Most accurate determination of pulse deficit calculated by two persons at the same time – Document findings - AP