TS: Apical Pulse

Define apical pulse

a pulse count taken with a stethoscope at the apex of the heart

5 times an apical pulse would be ordered

• a physician orders

• Irregular heartbeats (go ahead and take it then report it)

• Hardening of the arteries

• Weak/rapid radial pulse

• Children and infants

Describe the sound of a heartbeat

2 separate sounds

• opening and closing of the valves

• lubb-dupp = one heartbeat

What causes the audible heart sounds

Caused by the closing of the heart valves as blood flow thru the chambers of the heart.

• Abnormal = report to supervisor

Define/explain pulse deficit

condition that occurs with some heart conditions

• heart pulse should always be higher than radial pulse

• Weak or pumping way too fast

2 causes of a pulse deficit

1) the heart is weak and does not pump enough blood to produce a pulse

2) tachycardia: heart beats too fast and there isn’t enough time for the heart to fill = heart does not produce a pulse per beat.

What is the most accurate way to measure a pulse deficit

• one person should count an apical pulse while another person is counting a radial pulse

  • If not possible: one person should check apical first then immediately check the radial.

How do you calculate a pulse deficit

Ex. 130 (apical) - 92 (radial) = 38 (pulse deficit)

What are the anatomical landmarks for the location of the apex of the heart

fifth intercostal space by the midclavicular line

How long do you count the apical pulse, and what 3 things must be noted?

• count 1 full minute

• Note the rate, rhythm, volume

How do you chart (record) an apical pulse to distinguish it from other pulse sites in the body

Note date, time, rate, rhythm, and volume; use A or AP to denote apical

• (radial & apical pulse: A80/R64)

How do you chart a pulse deficit

If there is a pulse deficit, then A80/R64 pulse deficit= 16 (80-64=16)

• Record all required info on patient’s chart or enter into computer:

  • Ex. date, time, AP 86 strong and regular, and your signature and title.