Assessing the pulse

Monitoring a client’s pulse forms part of the assessment of vital signs and assists nursing and medical staff in determining the client’s general health and well-being. The equipment needed comprises a watch with a second hand and an appropriate chart for recording. The procedures are outlined below.

Procedure	Rationale
Explain procedure and obtain consent	To gain informed consent and reduce anxiety
Wash hands thoroughly	To minimize the risk of cross-infection
Place fingertips over selected artery, apply gentle pressure and feel for pulse	To confirm position and identify pulse. If you apply too much pressure you may occlude the blood supply and therefore you will not be able to feel the 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	To elicit the rate
Note the rhythm (pattern) of the beats	To determine intervals between each beat and check the regularity. Any abnormal rhythm (arrhythmia) should be reported immediately
Record on appropriate chart (see Figure 4.1) and/or care plan and report any deviation in rate, rhythm or strength	Legal requirement to maintain documentation and safeguard client through good communications
Wash hands thoroughly	To reduce risk of cross-infection

Figure 4.1 Example of a care plan