Vital Signs
Vital Signs are a basic component of assessment of physiological and psychological health of a client. Duet 2 for ipad and mac. Body temperature, pulse, respiration and blood pressure are the signs of life. Assessment of vital signs allows the nurse to:
1. Identify specific life threatening conditions and plan the needing nursing interventions.
2. Detect changes in the client’s health status.
Vital signs/cardinal signs in a normal healthy individual remain constant. They are called “vital signs” because of the following reasons:
1. These findings are governed by vital organs and often reveal even the slightest deviation from the normal body functions.
- The apical pulse is palpated in count the pulse rate in infants. Characteristics of the Pulse Before assessing the pulse, nurse must be familiar with the normal characteristics of a pulse – the rate, rhythm, volume and tension. Rate Rate is the number of pulse beats in a minute. The normal rate in the resting adult is 60 to 100 per minute.
- The apical pulse rate is the assessment of the number and quality of apical sounds in 1 minute. Each apical pulse is the combination of two sounds, S1 and S2. S1 is the sound of the tricuspid and mitral valves closing at the end of ventricular lling, just before systolic contraction begins. S2 is the sound of the pulmonic and aortic valves.
2. The changes in the condition of the client, improvement or regression may be detected by the observation of these signs.
3. Significant variations in these findings may indicate problems relating to insufficient consumption of oxygen, blood depletion, electrolyte imbalance, bacterial invasion and other problems.
Apical pulse A pulse felt or heard over the part of the chest wall that lies over the apex of the heart. In healthy people this is roughly located at the left mid-clavicular line in the fourth intercostal space.
Apical Pulse Rate
4. Through these signs, specific information may be obtained that will help in the diagnosis of disease, the result of treatment, medications and nursing care.
5. Even the client’s emotional state may also cause a significant variation in the symptoms.
The normal body temperature is 37 degree celcius in adults
The normal pulse is 72/minute in adults
The normal blood pressure is 120/80 mm of Hg in adults
Apical Pulse Rate
Introduction Remote cameras for mac.
The Apical pulse refers to the cardiac activity felt by palpation over the precordium. Apex beat is the outermost and lowermost point of maximum cardiac activity felt by palpation over the precordium. Apical impulse is the inspectory correlate of apex beat.
Radial pulse is a peripheral pulse which is the result of beating of the heart as felt through the walls of radial artery. What is felt at the periphery (radial artery) is not the blood flowing through the arteries but the shock wave that travels along the walls of the arteries as the heart contracts each time producing a rhythmic wave.
Difference in features
Apical pulse is felt by palpation or feeling by the hand, over the precordium i.e. left chest region, with the patient in a lying or sitting position whereas the radial pulse is felt at the outer corner of the wrist joint.
Apical pulse can be evaluated with the help of a stethoscope placed over the 5th intercostal space, just inside the mid-clavicular line while the Radial pulse is palpated by the tip of three central fingers placed along the outer aspect of the wrist. The Radial pulse is counted for one minute as beats per minute (pulse rate) while the Apical pulse can be counted with the help of stethoscope for one minute (heart rate).
Difference in utility
The apical pulse defines the character of heart contractions better as it is much closer to the heart. Well sustained, strong contractions are seen in concentric left ventricular enlargement (due to hypertension, Aortic stenosis) and give the pulse a heaving character. Ill-sustained, strong contractions are seen in hyperdynamic states like anemia, thyrotoxicosis and fever and give it a different character. In mitral stenosis, a doctor might report a tapping apex beat. Volume of the radial pulse can be low in conditions like cardiac shock, hypotension due to blood loss, plasma loss as in dengue, etc.
Cardiac arrhythmias will result in irregular apical and radial pulse. Arrhythmia can be either regularly irregular (constant missed beats- bigeminy, trigeminy) or they can be irregularly irregular (ventricular flutter, ventricular fibrillation). When the apical and radial pulses are too fast then it is referred to as tachycardia and is seen in conditions like fever, trauma with blood loss, hyperthyroidism, anxiety, etc. The pulses can be slower than the normal range of 60-100 beats/minute and will be referred to as bradycardia which can be physiological in athletes, pathological in hypothyroidism, heart block, etc.
Radial pulse can provide information regarding the state of the blood vessel which is identified by the feel of artery between the two pulsations, normally soft but tends to become hard when atherosclerosed.
Palpation of both radial and apical pulse simultaneously is important to diagnose conditions like coarctation of aorta which produce a difference in the two pulses; it is more likely to have a slight delay in the radial pulse due to decreased supply of the blood to the lower limbs.
Summary:
The apical pulse is the rhythmic beating of the heart felt through the chest wall using a stethoscope or hand as a result of heart’s contractions. The radial pulse is the contractile wave that passes through the wall of the radial artery of the forearm due to heart’s contractions, felt along the wrist joint.
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