How to Take The Patient's Pulse
The heart is a pump that pushes blood into the arteries. With each heartbeat, there is a pulsing pressure as the blood goes into the arteries. The pulse therefore reflects the heartbeat. A normal adult pulse usually is from 60 to 80 beats a minute, but the range is 60 to100.
The pulse is faster in women than in men. It is much faster in children than in adults. The pulse increases with exercise and with stress, and when the patient has a fever. The pulse is also faster when the patient is losing blood. Some medications decrease the pulse rate and others increase it.
It is important to take the patients pulse to find out whether it is in the normal range, and whether it is regular or not. Most of the time the pulse is taken on the thumb side of the inner wrist; this is called the radial pulse.
A pulse can also be taken at several other places on the body. If you cannot get to the radial pulse because the patient has a bandage there, or you need to assess the pulse in a particular part of the body, use another site. Any pulse taken away from the heart is called a peripheral pulse.
To take the patients peripheral pulse, whether on the wrist or atanother site, you need a clock or a watch with a second hand.
- Use your index and middle fingertips or all three middle fingertips and apply moderate pressure over the pulse point, until you feel the pulsing. Never use your thumb because you have a pulse in your thumb that you could mistake for the patients pulse.
- Count the number of beats for a full minute. After that, if the pulse is normal, count for 30 seconds and multiply by two.
- Note whether the pulse is weak, normal, or too strong (bounding).
- Note whether the pulse is regular or not.
- If the pulse is faster or slower than usual for this patient, or the pulse is irregular or bounding or weak, report this to the nurse or doctor in charge.
How to Take an Apical Pulse
Sometimes a pulse may be so weak that you cannot hear it unless you listen to it near the heart. A pulse taken at the apex of the heart is called the apical pulse. To take an apical pulse, you need a stethoscope and awatch which shows theseconds.
- Wash your hands.
- Use an antiseptic wipe to clean the earpieces and diaphragm (the flat- edged piece of the stethoscope) if they are soiled.
- Find the pulse site on the left side of the chest.
- Put the earpieces of the stethoscope in your ears, with the ear pieces pointing or facing forward.
- Put the diaphragm over the apical pulse and listen for heart sounds, which sound like "lub dub."
- Note whether the spaces between heart sounds are regular or not. This is the rhythm of the heart beat.
- Note the strength or weakness (volume) of the heartbeat.
- Count the heartbeats for 30 seconds and multiply by 2 if the rhythm is regular; count them for 60 seconds if the pulse is irregular. This is the pulse rate.
- Wash your hands.
- Record the pulse rate, rhythm and strength.
