Vital Signs Pulse What is the Pulse A

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Vital Signs Pulse

Vital Signs Pulse

What is the Pulse? A blood wave created by contraction of the left ventricle

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

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

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

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,

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

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

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

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

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 temperature

Assessing Peripheral pulses

Assessing Peripheral pulses

Assessing Peripheral pulses

Assessing Peripheral pulses

Assessing Peripheral pulses

Assessing Peripheral pulses

Assessing Peripheral pulses

Assessing Peripheral pulses

Assessing Peripheral pulses

Assessing Peripheral pulses

Nursing Dx. Ineffective peripheral tissue perfusion r/to…. .

Nursing Dx. Ineffective peripheral tissue perfusion r/to…. .

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