Pulse (the pressure of the blood pushing against the wall of an artery as the heart beats) Sites where pulse may be felt Temporal – side of forehead Carotid – neck Brachial – antecubital space (crease of elbow) Radial – inner aspect of wrist; thumb side Femoral – inner aspect of upper thigh Popliteal – behind the knee Dorsalis pedis – on top of foot arch (pedal pulse)

Pulse Variables Rate – number of beats per minute Adults: 60-90 Men: 60-70 Women: 65-80 Children over 7: 70-90 Children 1-7: 80-110 Infants: 100-160 tachycardia- pulse rate too high bradycardia- pulse rate too low Rhythm – regularity of pulse regular or irregular Arrhythmia – irregular or abnormal rhythm Volume – strength or intensity of pulse Described by words such as thready, weak, strong, bounding

Measuring an Apical Pulse Taken at the apex of the heart with a stethoscope Done on patients with irregular heartbeats, hardening of the arteries, or weak or rapid radial pulses Each heartbeat makes “lubb-dupp” sound (caused by closing of heart valves) Pulse deficit Condition in which the apical pulse rate is higher than the rate at other pulse sites Caused by the heart being too weak or beating too fast To find pulse deficit, subtract peripheral pulse rate from apical pulse rate Example: apical pulse is 130, radial pulse is 92 (130-92=38), pulse deficit is 38

Factors which increase pulse rate Excitement Fever Shock Exercise Stimulant drugs Factors which decrease pulse rate Sleep Depressant drugs Heart disease