TAKING A RADIAL (WRIST) PULSE RATE
Nursing procedure: taking a radial pulse rate
- Watch with a second hand
HOW TO TAKE A RADIAL (WRIST) PULSE RATE
- Wash hands/hand hygiene. Rationale: Reduces transmission of microorganisms.
- Inform client of the site(s) where pulse will be measured. Rationale: Encourages participation and allays anxiety.
- Flex client’s elbow and place lower part of arm across chest. Maintains wrist in full extension and exposes artery for palpation. Rationale: Placing client’s hand over chest will facilitate later respiratory assessment without undue attention to the nurse’s action. (It is difficult for any person to maintain a normal breathing pattern when someone is observing and measuring.)
- Support client’s wrist by grasping outer aspect with thumb. Rationale: Stabilizes wrist and allows for pressure to be exerted.
- Place index and middle fingers on inner aspect of client’s wrist over the radial artery, and apply light but firm pressure until pulse is palpated. Fingertips are sensitive, facilitating palpation of pulsating pulse. The nurse may feel his or her own pulse if palpating with thumb. Rationale: Applying light pressure prevents occlusion of blood flow and pulsation.
- Identify pulse rhythm. Palpate pulse until rhythm is determined. Rationale: Describe as regular or irregular.
- Determine pulse volume. Quality of pulse strength is an indication of stroke volume. Rationale: Describe as normal, weak, strong, or bounding.
- Count pulse rate by using second hand on watch. For a regular rhythm, count number of beats for 30 seconds and multiply by 2. For an irregular rhythm, count number of beats for a full minute, noting number of irregular beats. Rationale: An irregular rhythm requires a full minute of assessment to identify the number of inefficient cardiac contractions that fail to transmit a pulsation, referred to as a ‘‘skipped’’ or irregular beat.