Apical and radial pulse rate are normally identical. Our radial pulse
reflects the heartbeat or apical pulse; that is pulse rate is the same
as the rate of the ventricular contractions of the heart. In case of
arrhythmia or clients with certain cardiovascular disorders specifically
Atrial fibrillation, Apical-Radial Pulse assessment may need to be
assessed to determine the discrepancy between the two pulse rates or
know as Pulse Deficit. This certain assessment can be taken by one or
two nurse. The Two-nurse technique is recommended because it is more
ASSESSING AN APICAL-RADIAL PULSE
To determine adequacy of peripheral circulation or presence of pulse deficit.
Clinical sing of hypovolemic shock (hypotension, pallor, cyanosis, and cold, clammy skin)
|Assemble equipment and supplies
- Watch with second hand or indicator.
- Antiseptic wipes
|For two-nurse technique, make it sure that the other nurse is available at this time
1. Explain to the client what you are going to do, why it is necessary, and how he can cooperate.
2. Wash hand and observe other appropriate infection control procedures.
3. Provide client privacy.
4. Place the client in appropriate position. Position the client
appropriately in a comfortable supine position or to a sitting position.
Expose the area of the chest over the apex of the heart.
5. Locate the apical and radial pulse sites. For pulse sites you may
visit Sites in Assessing a Pulse. In the two-nurse technique, one nurse
locates the apical impulse by palpation or with the stethoscope while
the other nurse palpates the radial pulse site. See Procedure of Radial
6. Count the apical and radial pulse.
1. Assess the apical pulse for 60 seconds.
2. Assess the radial pulse for 60 seconds.
1. Place the watch where both nurses can see it. The nurse who is taking the radial pulse may hold the watch.
2. Decide on a time to begin counting. The nurse taking the radial pulse says “start” at the same time.
3. Each nurse counts the pulse rate for 60 seconds. Both nurses end the
count when the nurse taking the radial pulse says “stop”.
4. The nurse who assesses the apical pulse also assesses the apical
pulse rhythm and volume. If the pulse is irregular, note whether the
irregular beats come at random or at predictable times.
5. The nurse assessing the radial pulse rate also assesses the radial pulse rhythm and volume.
7. Document the apical and radial pulse rates, rhythm, volume, and any
pulse deficit in the client record. Also record related data such as
variation in pulse rate compared to normal for the client and other
pertinent observations, such as pallor, cyanosis, or dyspnea.
1. To lessen anxiety and to promote cooperation.
2. To reduce transmission of microorganism.
4. This ensures an accurate comparative measurement.
2. This ensures the simultaneous counts are taken.
3. A full 60-seconds count is necessary for accurate assessment of any discrepancies between the two pulse sites.
|1. Relate pulse rate and rhythm to other vital signs, to baseline data, and to general health status.
2. Report to the physician any changes from previous measurements or any discrepancy between the two pulses.
3. Conduct appropriate follow-up such as administering medication or
other actions to be taken for a discrepancy in Apical and Radial pulse
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