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Pulse assessment is the detection of a patient's pulse.
Pulse assessment is performed to establish a baseline on a patient's admission (from which to compare any significant changes), and to detect any abnormalities from the healthy state.
As there may be no prior knowledge of the patient's previous pulse recordings for comparison, it is important for the nurse or other health professional to know the range of normal values that apply to patients of different ages. Any known medical and surgical history or abnormal readings of any of the vital signs, as well as details
of any current medication the patient is taking, should be obtained. Exertion, such as climbing stairs, may affect the results. Therefore the patient should have rested prior to having their pulse taken, and refrained from consuming tobacco, caffeinated drinks, and alcohol 30 minutes prior to the procedure. Of course, these precautions cannot be taken in an emergency situation.
The pulse is checked as one indicator of abnormalities of the heart by observing the rate, rhythm, and the strength and tension of the beat against the arterial wall. The pulse may be recorded hourly to every four hours, or p.r.n. (when required), based on the patient's condition. For example, the pulse may be recorded postoperatively every 15 minutes in the recovery room.
The equipment required for pulse assessment is a watch with a sweep second hand or a digital readout. The pulse may be read where a surface artery runs over a bone, e.g. the radial artery (in the forearm), carotid artery (in the neck), temporal artery (at the temple), popliteal artery (at the back of the knee), or dorsalis pedal artery (at the instep). The radial artery in the wrist is the option used most often. The physician may choose such sites as the carotid artery pulse if atrial or ventricular problems are suspected.
To take the radial pulse, the patient should be sitting or lying comfortably, so that the readings are taken in similar positions each time and that there is little excitement to affect the results. The patient's forearm should not be raised to a level higher than the heart, as this position will change the reading. The nurse should place the index, middle, and ring fingers over the radial artery, which is located above the wrist on the anterior surface of the thumb side of the wrist. Apply gentle pressure to avoid obstructing the patient's blood flow. The rate, rhythm, strength and tension of the pulse should be noted. Using a watch, the pulsations that are felt where the artery rests against the bone are counted for half a minute, and the result doubled to give the beats per minute. However, any irregularities noted within the 30-second count means that the pulse should be recorded for one full minute to avoid any discrepancies.
Author Info: Margaret A. Stockley RGN, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.
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