Vitals sign pulse

Vital SignPULSE

Presented By:

Kiran Suwal

Vital Signs

• Vital signs are physical signs that indicate an individual is alive, such as heart beat, breathing rate, temperature, blood pressures and recently oxygen saturation.

• They are the measurement of the body’s most basic functions.• These signs may be observed, measured, and monitored

to assess an individual’s level of physical functioning.• Normal vital signs change with age, sex, weight, exercise,

tolerance and condition.

Normal Vital Sign Ranges

• Normal vital sign ranges for the average healthy adult while resting are:

Blood pressure: 90/60 mm/Hg to 120/80 mm/HgBreathing: 12 to 18 breaths per minutePulse: 60 to 100 beats per minuteTemperature: 97.8°F to 99.1°F (36.5°C to 37.3°C)/average

98.6°F (37°C)

Pulse

• Pulse is the wave of expansion and recoll occurring in an artery in response to the pumping action of heart.

• The pulse rate is a measurement of the heart rate, or the number of times the heart beats per minute.

• Taking a pulse not only measures the heart rate but also indicate following:

Heart rhythmStrength of the pulse

Characteristics of pulse1. Pulse rate : It is the number of pulse beats per minute. Normal

pulse rate in adults varies from 72 to 80 beats per minute.2. Rhythm or regularity: It is the time interval between pulse

beats. Normally the time intervals between pulse beats are equal or regular.

3. Tension : It is degree of compressiblty and depends upon the resistance of the wall of the artery.

4. Strength/volume : It is the fullness of artery. It is force of blood felt at each beat.

Types of pulse (Based on Pulse Rate)

• Tachycardia: When the resting pulse rate increases to more than 100 beats per minute in an adult , this usuall indicates the abnormal condition and is called tachycardia.

• Bradycardia: A pulse rate of less than 60 beats per minute is called bradycardia.

Purposes of taking pulse

• To establish baseline date• To check abnormalities in rate, rhythm and volume• To monitor any changes in health status of the patient• To assess response of heart to cardic medications, activity,

blood volume and gas exchange• To check the peripheral circulation• To determine number of heart beat per minute.

Factors affecting the pulse

• Age• Sex• Exercise/activity• Stature• Emotions• Fever

• Blood pressure• Drugs• Disease conditions• Acute pain and anxiety• Position• Hypovolemia/hemorrhage

Factors affecting the pulse (Cont.…)

• Age: Very old person have slow pulse rate and

children will have faster beat.

Age Pulse Rate ( Per min)

Before Birth 140-150New Born 130-140

1st year 115-130

2nd year 100-1153rd year 90-1004th-8th year 86-908th-15th 80-86At adult 70-80At old age 60-70


• Sex : Females have a slightly higher pulse rate than males.• Exercise/Activity : Pulse rate is much faster during exercise.• Stature : The short and thin persons have a more rapid pulse than

tall and heavy.• Emotions : Anger or excitement increases the pulse rate temporally.• Fever : When body temperature is elevated, the pulse rate usually

increases as well. Pulse increases at a rate ofabout 10 beats per minute each degree rise of body temperature (10:10f)


• Blood pressure : When the blood pressure decreases, pulse rate may increase to increase the flow of blood. If the blood pressure increases, pulse rate may decreases to correct the blood flow.

• Drugs : Stimulant drugs increase the pulse rate. Depressant drugs decrease the pulse rate.

• Disease condition : Heart diseases, thyroid disease and other infections effect on pulse rate


• Acute pain and anxiety : Increase pulse.

• Severe and chronic pain : Decrease pulse.

• Hemorrhage : Loss of blood increases pulse rate because of demand of oxygen.

• Position : Slow while lying down and rapid while standing.

Sites for checking Pulse

• Temporal• Carotid• Apical• Brachial• Radial

• Femoral• Popliteal• Posterior

tibial• Dorsalis

pedis

Sites for checking Pulse (Cont.…)

• Radial : Inner aspect of the wrist on thumb site.

• Temporal : Over the temporal bone or superior and lateral to the eye.

• Carotid : At the side of the trachea where the carotid artery runs between the trachea and the sternocleidomastoid muscle.

• Apical : Left side of the chest in the 4th , 5th or 6th intercostals space in the midclavicular line.

• Brachial : Medially in the antecubital space, above the elbow.

Sites for checking Pulse (Cont.…)

• Femoral : Below inguinal ligament, midway between symphysis pubis and anterosuperior iliac spine of illium.

• Popliteal : Medial or lateral to the popliteal fossa with knees slightly flexed.

• Tibial : On the medial surface of the ankle behind the medial malleolus.

• Dorsalis pedis : Along dorsum of foot between extensor tendons of great and first toe.

• Facial : At the outer angle of the lower jaw.

Scientific principle for taking pulse

• Exercise, emotions and anxiety will cause increased pulse rate so take pulse when the patient is at rest.

• Finer tips sensitive touch will feel the pulsation.• There is pulsation in the thumb, which may be mistaken for

patient’s pulse so thumb is not used to count pulse.• Count the pulse for one full minute, especially when there is

irregularity.• Choose suitable site for taking pulse.

Scientific principle for taking pulse (Cont.….)

• Characteristics of the pulse vary with individuals and indicates the functions of the heart, conditions of the patient and nature of blood vessels so observe, rate, rhythm, volume and tension of pulse.

• Record pulse immediately.• Always note the apical pulse for patients are with

cardiovascular disease, on cardiac medications and critically ill.

Procedure of taking pulse

• Explain procedure to patient and check if the patient had been involved in any activity. If so, allow the patient to rest for 10 minutes before taking pulse because activity can increase the pulse rate.

• Select the pulse site. Usually radial pulse is selected.• Assist the patient to a comfortable position. For radial

pulse, keep the arm, resting over chest or on the side with palm facing downward.

Procedure of taking pulse (Cont.….)

• Palpate and check pulse. Place tips of 3 fingers other than thumb lightly over pulse site.

Thumb is not used for assessing pulse as it has its own pulse which can be mistaken for patient’s pulse. Do not press the artery with more force.

After getting the pulse regularly, count the pulse for one whole minute looking a the second hand on the wrist watch.

Assess for rate, rhythm, and volume of pulse and condition of blood vessel.

• Assist client in returning to comfortable position.

Checking Radial Pulse Checking Carotid Pulse

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Education

Vitals sign pulse