” ASSESSING

PULSE”
PREPARED BY:
MARIE CECILLE LIBERTY S. VARILLA
INTRODUCTION
Pulse is the wave of blood created by contractions of the
left ventricle of the heart.

Compliance of the arteries is their ability to contract and

expand.

Cardiac output is the volume of blood pumped into the

arteries by the heart and equals the result of the stroke
volume times the heart rate per minute.
 Peripheral pulse is a pulse located
away from the heart, for example, in
the foot or wrist.

 Apical pulse is the central pulse; that

is, it is located at the apex of the heart

 Pulse rhythm is the pattern of the

beats and the intervals between the
beats
 FACTORS AFFECTING THE PULSE:
 AGE
 GENDER
 EXERCISE
 FEVER
 MEDICATION
 HYPOVOLEMIA
 STRESS
 POSITION CHANGES
 PATHOLOGY
PULSE SITES
APICAL
BRACHIAL
CAROTID
DORSALIS PEDIS
FEMORAL
POPLITEAL
POSTERIOR TIBIAL
RADIAL
TEMPORAL
 ALTERATIONS IN PULSE
RATE
1. Tachycardia – a heart rate that is more than the upper limit
which is 100bpm

2. Bradycardia – a heart rate that is less than the lower limit

which is 60bpm

3. Dysrhythmia/ arrythmia – pulse with an irregular rhythm

 ACCEPTABLE RANGES OF
NORMAL PULSES/HEART RATE
AGE HEART RATE(beats/minute)

Infant 120-160
Toddlers 90-140
preschoolers 80-110
School-agers 75-100
adolescent 60-90
Adult 60-100
 LIFESPAN
CONSIDERATIO
NS
 INFANTS
 Use apical pulse for the heart rate of newborns, infants, and
children under2-3 years old to establish baseline data for
subsequent evaluation, to determine whether the cardiac rate is
within normal range and to determine the rhythm

 Place the baby in supine position, and offer a pacifier if the baby
is crying or restless.

 Locate the apical pulse in the fourth intercostals space, lateral to

the midclavicular line during infancy

 Brachial, popliteal, and femoral pulses may be palpated.

 CHILDREN
 To take a peripheral pulse, position the child comfortably in the
adult’s arm, or have the adult remain close by

 To assess the apical pulse, assist a young child to a comfortable

supine or sitting position

 Demonstrate the procedure to the child using a stuffed animal or

doll, and allow handling the stethoscope before beginning the
procedure.

 The apex of the heart is normally located in the 4 th intercostals

space in young children; fifth intercostals space in children above
 ELDERS
 If client has severe hand or arm
tremors, the radial pulse may be
difficult to count

 Often have decreased peripheral

circulation so that pedal pulses
should be checked for regularity,
volume or symmetry
 STETHOSCOPE
1. Earpiece- should follow the contour of the
ear canal, pointing toward the face when
the stethoscope is in place
2. Binaural
3. polyvinyl tubing – around 30-40cm (12-18
in. long)
4. bell chest piece – transmits low-pitched
sounds created by the low velocity
movement of blood (like heart and
vascular sounds)
5. diaphragm chest piece – transmit high-
pitched sounds created by high velocity