Vital Signs Pulse What is the Pulse A

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 v Arteries in the arm – Brachial – Ulnar – Radial v 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) 5 th. Intercostal space MCL. Clean ear piece and diaphragm by antiseptic gel Warm diaphragm before use Assess for “lub-dub”

Assessing pulse Rate : tachycardia (100 B/m), bradycardia (60 B/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…. .