PULSE

Stephanie Oliver, DNP, RN

• It is an indicator of circulatory status
• The normal pulse varies according to age
 Infants 100-160
 Preschoolers 80-110
 School age 70-100
 Adolescent 60-90
 Adult 60-100
• The pulse is a palpable bounding of blood flow
noted at various points on the body (pressure of
the blood pushing against the walls of an ARTERY).
PULSE POINTS
•Temporal
•Carotid
•Apical
•Brachial
•Radial
•Ulnar
•Femoral
•Popliteal
•Posterior Tibial
•Dorsalis Pedis
PULSE CHARACTER
Rate
 Number of beats per minute (60-100)
Rhythm
 Interval between contractions of ventricles (regular, irregular)
Strength
 Volume of blood ejected against the arterial wall graded as strong, weak,
thready, bounding
Equality
 Are pulses the same on both sides of the body
 COUNTING THE PULSE
• Radial is most logical spot:
pt sitting or lying down
two fingers over radial pulse
compress gently
determine strength
note sweep hand on watch
determine start number
begin count
regular pulse,, count 30 sec multiply by 2
**irregular pulse…count for full minute
APICAL PULSE (PMI)

• Point of maximal
impulse is located
midline fifth
intercostal space
midclavicular line
COUNTING THE APICAL PULSE
• Use on infants, patients with heart failure, abnormally
fast heartbeat, some meds require the apical pulse to
be checked before administering
• When pulse is irregular it may be necessary to
determine the pulse-deficit:
 This requires two nurses
 One to count the radial pulse one to count the apical pulse (pulse at apex of
heart)
 This is done at the same time
 Subtract the radial pulse from the apical (example: radial = 96, apical =100,
pulse deficit = 4)
 If radial pulse is higher than the apical pulse, do the assessment again, it is not
possible