1. Pulse

2. Pulse
Lessons 1. Pulse Go
TABLE OF CONTENTS

3. Lesson 1- Pulse
Pressure of blood pushing against wall of artery as the heart contracts
Several pulse sites on body
Abnormalities can signal disease
Pulse
Pulse is one of the four vital signs. Pulse is the pressure of the blood pushing against the wall of the artery as the heart contracts, or beats.
The pressure of the blood pushing against the artery wall can be felt, and in some cases seen, at several pulse sites on the body. As with all vital signs, abnormalities in pulse can signal disease.

4. Lesson 1– Assessing Pulse
Rate: number of beats per minute
Rhythm: pattern of beats
Volume: character, or strength, of beats
Assessing Pulse
Pulse is assessed by three categories: rate, rhythm, and volume. Rate is the number of beats per minute. Rhythm is the pattern of the beats. And volume is the character, or strength, of the beats.

5. Lesson 1– Pulse Sites
Detected where superficial artery has a bone behind it
Sites often named according to nearby bones or structures
Most common sites are radial and brachial
Pulse Sites
There are several sites on the body where pulse can be detected, or felt. Pulse can be detected where a superficial artery has a bone behind it. The sites are often named according to the bones or structures near where they are found. The most common pulse sites are radial and brachial.
Common pulse sites include:
Radial
Temporal
Carotid
Brachial
Femoral
Popliteal
Dorsalis Pedis

6. Lesson 1– Palpation and Auscultation
Palpation: Examination by applying slight pressure to a pulse point with fingertips
Auscultation: Examination by listening, usually with a stethoscope.
Ex., apical pulse
Palpation and Auscultation
Palpation and auscultation are ways to measure pulse.
Palpation involves examination by touching with fingers or hands. Specifically, the fingertips are used when taking a pulse. The fingers are used to apply slight pressure to a pulse point so that the beats that are felt can be counted. The thumb should not be used because it has a pulse of its own and could be confused with the patient’s pulse.
Auscultation involves examination by listening to the sounds of the body. Typically, auscultation is done indirectly, using a stethoscope. Auscultation is used for taking apical pulse—listening to the heartbeat.

7. Lesson 1– Pulse Rate Increase pulse Decrease pulse
Exercise, stimulants, excitement, fever, shock
Decrease pulse
Sleep, depressants, heart disease, coma
Abnormally high or low pulse can signal disease, such as Bradycardia and Tachycardia.
Pulse Rate
Average pulse rate varies for men, women, and age groups of children.
For adult males, the range is 60 to70 beats per minute.
For adult females, the range is 65 to 80 beats per minute.
For children over age seven, the range is 70 to 90 beats per minute.
For children ages 1 through 7, the range is 80 to110 beats per minute.
And for infants, the range is 100 to 160 beats per minute.
An increased pulse rate can result from exercise, stimulant drugs, excitement, fever, shock, and nervous tension. A decreased pulse rate can result from sleep, depressant drugs, heart disease, coma, and physical training.
Bradycardia is an abnormally low pulse rate, under 60 beats per minute. Tachycardia is an abnormally high pulse rate, over 100 beats per minute except children. As with all vital signs, abnormal pulse can signal disease.

8. Lesson 1– Pulse Rhythm Regular: equal spacing of beats
Irregular: Unequal spacing of beats
Arrhythmia is abnormal rhythm
Pulse Rhythm
Pulse rhythm is described as regular or irregular.
Regular pulse rhythm has an equal spacing of beats.
Irregular pulse rhythm does not have equal spacing between beats.
Arrhythmia is an abnormal rhythm. Arrhythmia can be caused by a defect in the electrical conduction pattern of the heart or by blockages in the coronary arteries of the heart.

9. Lesson 1– Pulse Volume Described as strong, weak, thready, or bounding
Often recorded using numbers
0= Absent
1= Thready
2= Strong
3= Bounding
Pulse Volume
Pulse volume can be described as strong, weak, thready, or bounding. Volume is often recorded using numbers.
0 = Absent, unable to detect
1 = Thready or weak, difficult to feel, easily stopped by light pressure from fingertips
2 = Strong and normal, easy to feel, able to be stopped by strong pressure from fingertips
3 = Bounding and full, difficult to stop with fingertips

10. Lesson 1– Apical Pulse Apical pulse is patient’s heartbeat
Stethoscope is placed over apex of the heart
Used for infants, small children, and patients with certain illnesses
Apical Pulse
Apical pulse is a patient’s heartbeat. A stethoscope is used to take, or auscultate, apical pulse. The diaphragm of the stethoscope is placed over the apex of the heart. The heartbeats are heard and counted for one full minute. Apical pulse might be used for infants or small children and for patients with certain illnesses.

11. Lesson 1– Apical/Radial Pulse Deficit
Normally, apical and radial pulses are the same.
Difference between apical and radial pulse rates
Subtract radial pulse from apical pulse
Occurs if:
Heart is too weak to produce a pulse
Heart beating too fast to fill with blood
Apical/Radial Pulse Deficit
Apical pulse and radial pulse should be the same. For example, if a patient’s heart beats 67 times per minute, then 67 pulses per minute should be counted at the wrist. If fewer pulses than heartbeats are felt, it is called a pulse deficit.
A pulse deficit can occur if the heart is too weak to pump enough blood to produce a pulse. It can also occur if the heart is beating so fast that the heart cannot fill with blood.
The pulse deficit is the difference between the apical pulse and the radial pulse rates. It is determined by subtracting the number for the radial pulse from the number for the apical pulse.