Assessing Apical–Radial Pulse

Vital Signs

• Normal range for rectal temperature is not specified (but generally 36.5°C - 37.5°C)
• Rectal temperature measurement is contraindicated in patients with rectal bleeding, bleeding disorders, or anal fissures

Heart Rate

• Normal range for pulse rate in adults is 60-100 beats per minute (bpm)
• The parasympathetic nervous system, specifically the vagus nerve, decreases heart rate
• Stimulating the vagus nerve during rectal temperature measurement can cause heart rate slowing
• Tachycardia is defined as a heart rate above 100 bpm

Pulse Assessment

• Pulse Amplitude Scale grading of +3 indicates a pulse that is very strong and full
• A weak and thready pulse quality indicates decreased peripheral circulation
• Unequal intervals between beats and pauses during pulse rhythm assessment indicate irregular rhythm
• The stethoscope is typically used for assessing apical pulse
• Apical pulse is assessed over the apex of the heart to detect cardiac irregularities and murmurs
• A pulse deficit (difference between apical and radial pulse rates) indicates a cardiac irregularity

Respiratory System

• Oxygen and carbon dioxide exchange occurs between alveoli and circulating blood in the lungs
• Chemo receptors play a role in respiratory control by detecting changes in CO2 and O2 levels

Blood Pressure

• Respiration is a vital sign that can be affected by changes in blood pressure
• The popliteal artery is used for assessing blood pressure in certain situations (e.g., peripheral artery disease)
• Falsely high blood pressure assessments can occur due to incorrect cuff size or improper technique

Oxygen Saturation

• Normal range for oxygen saturation levels is 95-100%
• Factors that do not affect oxygen saturation include room temperature and humidity
• Pulse oximetry is useful for monitoring patients because it provides continuous, non-invasive oxygen saturation and heart rate monitoring.