Pulse Flashcards
What is the pulse?
wave created by 5 Tbs. of blood being pumped into the arteries with every heartbeat.
What are you measuring when you take pulse?
rate, rhythm, and amplitude
Which pulse is taken as a quick screen of heart function?
checking radial pulse for 30 seconds
How do you take a radial pulse?
1st 2 fingers compress radial artery against radius
What is the normal adult resting rate range?
60-90 bpm
What is the average adult resting rate?
72 bpm
What is bradycardia?
less than 60 bpm
What is tachycardia?
more than 100 bpm
What is physiologic tachycardia?
normal response to exertion, anxiety, or elevated temperature, exercise and excitement.
What is the rate for physiologic tachycardia?
10 bpm for every degree over 100
What is pathologic tachycardia?
response to an oxygen deficit
What examples can cause pathologic tachycardia?
anemia, hemorrhage, shock or congestive heart failure
What is the normal rhythm like for pulse?
REGULAR, steady, consistent
What are arrhythmias?
irregular heartbeats
What kind of arrhythmias are there?
regular and irregular
What are three common irregularities of pulse?
sinus arrhythmia
premature ventricular contraction (PVC)
atrial fibrillation
Which pulse irregularity is common in children?
sinus arrhythmia
What is sinus arrhythmia?
heart rate speeds up with each inspiration and slows again with expiration
What is premature ventricular contraction?
ventricular depolarization occurs earlier than expected resulting in occasional skipped beats
How can PVC show up?
a regular pattern of skips or
several sequential skips
What is atrial fibrillation?
disorganized electrical activity in the atria accompanied by a rapid, irregular ventricular response.
Atrial fibrillation is significant how?
usually accompanies pre-existing heart disease and necessitates emergency care
What is characterized by alternation of pulsation of small amplitude with pulsation of large amplitude while the rhythm is regular?
pulsus alternans (alternating pulse)
What is the best way to detect pulsus bisferiens?
palpation of the carotid artery
What are the two main peak called in pulsus bisferiens?
percussion wave and second, tidal wave
The first peak in pulsus bisferiens is believed to be what?
pulse pressure
The second peak in pulsus bisferiens is believed to be what?
reverberation from the periphery
Normal pulsation followed by a premature contraction is known as what?
bigeminal pulse
What is the amplitude of the premature contraction like?
less than the normal pulsation
This is characterized by an exaggerated decrease in the amplitude of pulsation during inspiration and increased amplitude during expiration?
paradoxic pulse (pulsus paradoxus)
What is amplitude of the pulse?
perceive FORCE of the wave generated by blood being ejected from the left heart
What is used to grade pulse amplitude?
a scale of 0-4
pulse amplitude of 0 =
absence
pulse amplitude of 1 =
weak, thread or feeble
What kind of pressure stops the pulse in grade 1 amplitude?
light pressure
pulse amplitude 2 =
expected or typical
Does a light pressure stop the pulse in grade 2 amplitude?
no
pulse amplitude of 3 =
full or increased
T/F A firm pressure will stop the pulse in grade 3 amplitude?
FALSE
pulse amplitude of 4 =
bounding, water-hammer
What stops a grade 4 pulse amplitude?
only heavy pressure
What is another name for a grade 4 amplitude pulse?
Corrigan pulse
A healthy heart and arteries produce what sort of contour?
smooth, domed shape wave form
Neural paresthesia affect:
all or part of a dermatome
Vascular paresthesia is different that neural paresthesia how?
it crosses dermatomes
Vascular paresthesia may present with:
a cooler and discolored extremity including cyanosis
Amplitude may be diminished in that extremity
capillary refill time may be greater than 2 seconds
What are the palpable arteries for the head?
carotid and temporal
What are the palpable arteries to the hands?
subclavian, brachial, and radial
What are the palpable arteries to the feet?
femoral, popliteal, posterior tibial and dorsal pedis
Bilateral pulses are compared for what?
amplitude and contour
What is the expected finding in upper and lower extremities?
+2 bilaterally on a 0-4 scale
Unequal amplitude between left and right extremities suggest …?
impaired circulation on the low side.
On peripheral vascular assessment, one side may feel weaker because and arterial lumen is ?
constricted, compressed, or turbulence within an aneurysm
Constriction could be because what?
vasoconstriction, atherosclerosis, clot
Compression could be because?
swollen lymph node, TOS - thoracic outlet syndrom, Pancost tumor
What is a Pancost tumor?
lung tumor that forms at the top of the lungs
Upper and lower extremity pulses are compared for what?
equal amplitude
A strong radial and a weak or absent femoral pulse suggests what?
coarctation of the aorta
or some other form of constriction, compression, or obstuction
What is another means of assessing for arterial compromise?
capillary refill time
How do you check capillary refill time?
Blanch fingernail or toenail pressure for several seconds then release and time the return to full color.
When assessing capillary refill time, what time indicates arterial compromise?
more than 2 seconds
Arteries can also be auscultated for what?
bruit
What is bruit?
a typically low pitch, pulsed, and relatively quiet sound
What part of the stethoscope do you use in assessing bruit?
bell
The presence of bruit suggests what?
compressed, constricted, or partially obstructed arterial lumen.
How do you assess venous insufficiency?
patient is standing, inspect for swelling, varicosities, edema, erythema, and/or cyanosis…
