Vital Signs
Pulse
What is the Pulse?
A blood wave created by contraction of the
left ventricle
Compliance : Ability
of the arteries to
contract and expand.
Cardiac output: the
volume of the blood
pumped in the
arteries = SV X HR.
Factors affecting the pulse
Age
Gender
Exercise
Fever
Medications
Hypovolemia
Stress
Position changes
Pathology
PERIPHERAL PULSE
APICAL PULSE
-infants and children up to 3 years of age
-used once there is discrepancies with radial
pulse
-in conjunction w some medications such as
Digoxin.
Pulse sites
Temporal-when radial not
accessible
Carotid-cardiac arrest,
circulation to the brain
Apical
Brachial-Bp, cardiac arrest in
infants
Radial- most common and
accessible
Femoral-cardiac arrest, infant
and children, POVD
Popliteal, POVD,
Posterior tibial, Foot circulation
Pedal (dorsalis pedis), foot
circulation
Peripheral blood vessels
Arteries in the arm
– Brachial
– Ulnar
– Radial
Arteries in the leg
– Femoral
– Popliteal
– Posterior tibial
– Dorsalis Pedis
Assessing pulse
Palpation (60 sec.)
Middle three fingers
Using stethoscope
Doppler ultrasound
Moderate pressure
Aware of
(medications, activity,
position)
Assessing Apical pulse
Explain procedure
Privacy
Supine, or sitting position
Point of maximal impulse
(PMI)
5th. Intercostal space
MCL.
Clean ear piece and
diaphragm by antiseptic
gel
Warm diaphragm before
use
Assess for “lub-dub”
Assessing pulse
Rate : tachycardia (100B/m), bradycardia
(60B/m)
Rhythm : dysrhythmia, arrhythmia (ECG)
Volume : full bounding, weak, feeble,
thready
elasticity : straight, smooth, soft, pliable
Pulse deficit : any discrepancy b/w apicalradial pulses.
Assessing Peripheral temperature
Assessing Peripheral pulses
Assessing Peripheral pulses
Assessing Peripheral pulses
Assessing Peripheral pulses
Assessing Peripheral pulses
Nursing Dx.
Ineffective peripheral tissue perfusion
r/to…..