PULSE IN VITAL SIGNS BY NIDA FAREEN SUBJECT NURSING FOUNDATION FOR B.SC NURSING

PULSE IN VITAL SIGNS BY NIDA FAREEN SUBJECT NURSING FOUNDATION FOR B.SC NURSING

1. Topic presentation on pulse Presented by Ms. nida fareen Nursing tutor

2. Definition It is defined as the palpable sounding of the blood flow noted at various points on the body where the artery is near the surface and passes over a bone, when blood is pumped in to the arteries by the contraction of left ventricle.

3. Physiology and regulation of pulse Pulse is an electrical impulse that starts from the SA node and travel along the heart muscles which stimulates the heart contraction. The amount of blood ejected through the aorta in one contraction is called as stroke volume. When the stroke volume is ejected, the walls of aorta are distended, a wave travel rapidly from aorta to the distal end of the arteries. These pulse wave travel 15 times faster in the aorta and 100 times faster in the smaller arteries.

4. Factor affecting the pulse rate Age Body build size Blood pressure Medication Exercise and muscular activities Food intake Elevated body temperature Emotional status Pain

5. Pulse sites

6. Radial pulse : The radial pulse is taken at a point where the radial artery crosses the bones of the wrist. Carotid pulse: The carotid pulse is on either side of the trachea. Brachial pulse : The brachial pulse is taken in the depression located about one-half inch above the crease on the inside of the elbow. Temporal pulse: The temporal pulse is taken in the temporal area on either side of the head. It is located in front of the upper part of ear.

7. Ulnar artery: like the radial pulse is taken at the wrist. The radial pulse is taken over the artery on the thumb side of the wrist while the ulnar pulse is taken on the palm side of the wrist. Femoral pulse: The femoral pulse is taken in the groin area by pressing the right or left femoral artery against the ischium.

8. Popliteal pulse: The Popliteal pulse is taken in the middle of the area located on the inside of the knee. Posterior tibial pulse: The Posterior tibial pulse is taken at the top of the ankle or just above the ankle on the back, inside part of the ankle. Apical pulse: The apical pulse is not taken over an artery. it can be felt over the apex of the heart. Dorsalis pedis: The dorsalis pedis pulse is taken on the top portion of the foot just below the ankle.

9. Alteration in pulse Pulse rate: rate means number of pulse in one minute. The normal range is 60-80 beats per minute and average is about 72 beats per minute. Age group Pulse rate/ Minute INFANT 120-160 BEATS/ MIN TODDLER 90-140 BEATS/MIN PRESCHOOLER 80-110 BEATS/MIN SCHOOL AGE CHILD 75-100 BEATS/MIN ADOLESCENT 60-90 BEATS/MIN ADULT 60-100 BEATS/MIN

10. Pulse Rhythm Rhythm is the regularity of the beats. Rhythm may be normal or abnormal. The irregular rhythm is present in following condition . Atrial fibrillation Ventricular fibrillation Intermittent pulse Extrasystole Sinus arrhythmia

11. Tension It is the degree of compressibility, tension depends upon the resistance offers on the walls of the artery. Abnormal tension Low tension The pulse is easily compressed or described as: Bonding pulse: it denotes an increased stroke volume, which can be palpable by finger tips slightly. Thready pulse: the pulse is weak and diminished, which is barely palpated by finger tips.

12. High tension When force of blood increases on the wall of artery it is known as high tension. Dicrotic pulse: there is one heart heat and two arterial pulsation giving the sensation of double beat. Water hammer pulse or Corrigan’s pulse: This type of pulse is found in aortic regurgitation, when valve gas loose .

13. Volume It means strength of the artery. It is the force of the blood felt at each beat. It depends upon the amount of the blood in the arteries. The abnormal volume is seen in the following conditions: 1. Full bounding pulse: In anxiety, anemia, exercise or exertion activities due to increase in stroke volume. 2. Pulsus alternans: In this condition rhythm is regular, but one beat is stronger followed by weak and again stronger beat.

14. 3. Feeble pulse: In this stroke volume get decreased leading to weak pulse.

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