Monitoring a

client’s pulse


The pulse is a wave of pressure produced by the expansion of an artery due to contraction of the left ventricle of the heart.

The pulse can be felt with the fingertips at the following points:

  • temporal – the temple
  • carotid – the side of the neck
  • brachial – the antecubital fossa (crook) of the arm
  • radial – in the wrist below the thumb
  • femoral – in the groin
  • popliteal – behind the knee
  • posterior tibial – to the side of the ankle
  • dorsalis pedis – on the front of the foot.


Other terminology used when monitoring the pulse include:

  • tachycardia – a pulse above the normal range
  • bradycardia – a pulse below the normal range.

Many factors influence the pulse and these include:

  • age
  • gender
  • physique
  • body temperature
  • haemorrhage
  • exercise
  • stress
  • some prescribed medications, for example digoxin, tricyclic antidepressants, caffeine, nicotine, alcohol
  • some illegal substances, for example ecstasy.


Procedure

  • Explain procedure and obtain consent
  • Wash hands thoroughly
  • Place fingertips over selected artery, apply gentle pressure and feel for pulse
  • Begin to count pulse and, using a watch, follow the sweeping second hand for 60 seconds
  • Normal ranges (beats per minute):
    • Newborn: 70–190
    • 2–5 years: 80–160
    • 6–14 years: 70–120
    • Adult: 55–90
  • Note the rhythm (pattern) of the beats
  • Record on appropriate chart and/or care plan and report any deviation in rate, rhythm or strength
  • Wash hands thoroughly