12) Character Of The Pulse Flashcards
1
Q
What characteristics are assessed when palpating the radial pulse?
A
Rate, rhythm, strength, and bilateral equality
2
Q
What characteristics are assessed when auscultating the apical pulse?
A
Rate and rhythm only
3
Q
What should be done before measuring a pulse?
A
- Review the patient’s baseline heart rate for comparison
- Some practitioners measure baseline rates in lying, sitting, and standing positions
4
Q
How does a change in position affect heart rate?
A
- Changing from lying to sitting/standing temporarily increases heart rate
- Due to alterations in blood volume and sympathetic nervous system activity
5
Q
What factors influence heart rate?
A
- Various factors like age, medications, exercise, emotions, temperature, etc.
- A single factor or combination can cause significant changes
6
Q
What should be done if an abnormal peripheral pulse rate is detected?
A
- Assess the apical pulse rate by auscultating heart sounds
- Provides a more accurate assessment of cardiac contractions
7
Q
What factors increase heart rate?
A
- Short-term exercise
- Fever and heat
- Anxiety (increases sympathetic stimulation)
- Acute pain (increases sympathetic stimulation)
- Positive chronotropic medications like epinephrine
- Cholinergic blocking agents like atropine
- Loss of blood (increases sympathetic stimulation)
- Standing up from sitting position
- Diseases causing poor oxygenation like asthma, COPD
8
Q
What factors decrease heart rate?
A
- Long-term exercise (conditions the heart for lower resting rate)
- Hypothermia
- Relaxation
- Unrelieved severe pain (increases parasympathetic stimulation)
- Negative chronotropic medications like digitalis, beta-blockers, calcium channel blockers
- Lying down
9
Q
How should the nurse identify heart sounds?
A
- S1 is the first heart sound, low-pitched and dull (“lub”)
- S2 is the second heart sound, higher pitched and shorter (“dub”)
- Each “lub-dub” set counts as one heartbeat
10
Q
How does the nurse count the heart rate?
A
- Using the diaphragm or bell of the stethoscope
- Count the number of “lub-dub” sets in 1 minute
11
Q
What is the normal heart rate range in adults?
A
- Between 60 and 100 beats per minute
12
Q
What is tachycardia?
A
- Fast heart rate, more than 100 beats per minute in adults
- If resting rate is over 120 bpm, may indicate underlying problem
13
Q
What is bradycardia?
A
- Slow heart rate, less than 60 beats per minute in adults
- Can occur from heart block or medications like beta-blockers
- Often seen in athletes at rest
14
Q
What is a pulse deficit?
A
- Inefficient heart contraction that fails to transmit pulse wave peripherally
- Detected by two people simultaneously assessing apical and radial rates
- Difference between the two rates is the pulse deficit
- Associated with abnormal rhythms
15
Q
What is a normal pulse rhythm?
A
- Regular interval between each pulse/heartbeat
- Pulse should be regular under normal circumstances
