Measuring Heart Rate
As the heart pumps blood to the body, the blood causes a pressure wave against the arterial walls called a pulse, which correlates with the heart rate, or the number of heart beats per minute.
As the nurse, you’ll measure your patient’s pulse and evaluate its characteristics including rate, rhythm, and amplitude.Pulse Measurement The pulse can be felt in the superficial arteries close to the skin, including the radial, carotid, brachial, femoral, popliteal, posterior tibial, and dorsalis pedis.
The radial artery is the most common site because it’s easy to access. To locate the radial pulse, place the flat part of your middle two or three fingers on the anterior of the patient’s wrist, just under the thumb.
Then, to feel the pulse, you’ll use your fingers to firmly palpate the artery, being careful not to obliterate it.Now, if your patient’s pulse is abnormal, or if they have heart disease or are taking medications that affect their pulse, count an apical pulse, or the pulse that’s heard right over the heart using your stethoscope.
To measure the apical pulse, place your stethoscope at the apex, or lowest portion, of the heart on the left side of the chest between the 5th and 6th ribs.
The rhythm is the measurement of the intervals between heart beats. If these intervals are equal, the rhythm is considered regular.
On the other hand, if the intervals are unequal, the rhythm is considered irregular, and is known as an arrhythmia. To determine the rate when the rhythm is regular, count the pulsations for thirty seconds, and then multiply that number by two to calculate the beats per minute.
A pulse can be graded on a scale of 0 to 4+, where 4+ is a bounding pulse against your fingertips; 3+ is a strong, full, pulse, 2+ is considered normal; 1+ is diminished and is often described as weak and thready.
Lastly, a pulse that’s absent or not palpable is graded as 0.Okay, normal heart rate for adults is between 60 and 100 beats per minute and regular.
In infants and children, the rate varies based on age, with the pulse being higher in younger children and gradually decreasing until adulthood.
Many factors can cause a pulse to move faster or slower, including physical activity, body temperature, medication, or emotions, like anger, fear, or stress.A pulse rate that’s faster than normal is called tachycardia, while a rate slower than normal is called bradycardia.
Tachycardia can occur in response to strenuous exercise, fever, pain, anxiety, or specific medications; whereas bradycardia can result from heart problems, like heartfailure, or medications, like beta blockers.
An arrhythmia can be temporary, like when a patient has an electrolyte imbalance, or continuous, like when a patient has a chronic heart condition, like atrial fibrillation.
A bounding pulse can result from an abnormally forceful heartbeat, like in a patient with hypertension or fluid overload.
In contrast, a weak or thready pulse is typically considered an emergency and could be an indication of low blood pressure or blood volume.Keep in mind, each patient’s pulse varies, so it’s essential to know what their baseline is.
For example, some athletes may have a resting heart rate of 45 beats per minute which is normal for them but would be concerning for someone else.
If your patient’s pulse is abnormal and unexpected for them, you will notify the registered nurse. Alright, as a quick recap...The pulse is a pressure wave that occurs when the heart pumps blood to the body and correlates to the heart rate.
When measuring a pulse, be sure to report any abnormalities
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