In this note, you will learn how to take pulse rates in nursing, both manually and using a pulse oximeter
Pulse is the expansion of the artery wall due to pressure from the blood being pumped from the heart through the artery to the rest of the body. It is felt from the artery whenever it passes over the bone. Pulse represents how the heart is beating.
Table of Contents
A common term used when describing a pulse
Dicrotic pulse is a term used to describe a double pulse rate
Bradycardia is an abnormally slow pulse rate. (pulse rate lower than normal)
Tachycardia is a rapid pulse rate (pulse rate higher than normal)
Irregular pulse is an uneven beat.(when pulse pauses or is interrupted)
Sites for taking the pulse rate in the body
We have many sites in the body where pulse can be taken from; this provides many options for reading pulse.
Pulse sites in the body
- The temporal artery is located on the side of the forehead, just above and in front of the ear
- The carotid artery is located on either side of the neck beside the trachea
- The brachial artery is located in the inner aspect of the upper arm near the elbow
- The radial artery is located on the thumb side of the wrist.
- The femoral artery is in the groin area
- The popliteal artery is located behind the knee.
- The posterior tibial artery is located behind and slightly below the inner ankle bone.
- The dorsalis pedis artery is on the top of the foot.
Normal ranges of pulse
Pulse has different ranges according to different age groups. Because the rate at which the heart beats is also different.
Adult
The normal pulse rate in adult range from 60 to 90 beats per minute
Children
The normal pulse rate in children ranges from 90 to 140 beats per minute
Infants
The normal pulse rate in infants ranges from 120 to 140 beats per minute
New born
The normal pulse rate in newborns ranges from 120 to 150 beats per minute
Observation made while taking pulse rate
Rate
This is several beats per minute. i.e., how many beats are recorded in 1 minute.
Volume
This is how strong the pulse is. This indicates the amount of blood flowing through the artery
Rhythm
This is an equal interval between the pulses, i.e., regularity of the pulse
Tension
This is the state of the artery wall.
Indications for taking pulse rates in nursing
- Critically ill patients to detect any abnormality early
- Before and after a blood transfusion to detect any reaction.
- Routine check of vital signs assessment
- During emergencies or shock, it will be weak.
- to assess the heart function, how well the heart is working.
- Before administering some medications like digoxin and other beta blockers
- Before, during, and after surgery.
- patients with heart diseases
Instrument used for taking pulse rate
- Pulse Oximeter.
- Monitor
- Hand used for feeling manually
Requirements for taking the pulse
A tray containing
- Nurses watch for timing.
- A chart for recording the pulse.
- Pen for recording the pulse
Procedure on how to take pulse rates in nursing
- Explain the procedure to the patient or their attendant to obtain their consent and build trust.
- Screen the bed to provide privacy
- Bring the tray near the patient’s bedside for easy access to the instrument
- Position the patient in the sitting pu position or lying in a comfortable position
- Wash hand.
- Place the first three fingers over the artery, and apply steady pressure
- Start counting the beat silently and make your observation while feeling the pulse for one minute
- Give the findings to the patient
- Thank and leave the patient comfortably
- Wash hand
- Record the pulse in the patient’s chart and report any abnormality
Note
Pulse is always taken together with temperature while the thermometer is in place.If the pulse is normal in any way, count for 15 seconds and then multiply by 2 to make a full count. this only for the manual way.
Common Mistakes to Avoid When Taking Pulse Rate
- Using the thumb
- Pressing too hard
- Incorrect counting
- Poor finger placement
- Ignoring rhythm and strength
- Poor documentation
- Talking while taking the pulse rate
When to Notify a Doctor
- Tachycardia
- Bradycardia
- Irregular pulse
- Weak or thready pulse
- Bounding pulse
- Absent pulse
What is a Normal Pulse Rate by Age?
Newborn
100–160 bpm
Infant (1–12 months)
100–150 bpm
Toddler (1–3 years)
90–140 bpm
Preschool (3–5 years)
80–110 bpm
School-age child
75–100 bpm
Teenager
60–100 bpm
Adult
60–100 bpm
Older adults
60–100 bpm
What is the Difference Between Heart Rate and Pulse?
Heart rate is the number of times the heart beats per minute.
Pulse is the feeling of blood moving through the arteries as the heart beats.
What Does a “Weak and Thready” Pulse Mean?
A weak and thready pulse is difficult to feel and may indicate: Shock, Blood loss,Dehydration and Poor circulation
Is a Pulse Rate of 100 Beats Per Minute Too High?
A pulse of 100 bpm is at the upper limit of normal in adults.
A pulse of 100 bpm is at the upper limit of normal in adults.
The most common site is the radial artery located on the wrist below the thumb.
Why Shouldn’t You Use Your Thumb to Take a Pulse?
Your thumb has its own pulse, which may confuse the reading and give inaccurate results.
How Long Should You Count a Pulse if It Is Irregular?
Count for a full 60 seconds to get an accurate reading.
What Causes a Sudden Drop in Pulse Rate?
Possible causes include: Heart problems, Severe hypothermia, Medication effects, Shock, Increased intracranial pressure