Pulse Monitoring PDF

Pulse monitoring A pulse is a stroke/bump of blood stream on the walls of the aorta. Approximately 60 to 70 ml of blood enters the aorta and then the arterial circulation with each heart ventricular contraction (stroke volume). With each stroke volume ejection into an already full aorta, the wal...

Pulse monitoring A pulse is a stroke/bump of blood stream on the walls of the aorta. Approximately 60 to 70 ml of blood enters the aorta and then the arterial circulation with each heart ventricular contraction (stroke volume). With each stroke volume ejection into an already full aorta, the walls of the aorta distend (to compensate for the increase in pressure of the blood), creating a pulse wave that travels rapidly toward the distal ends of the arteries where can be felt (palpated). Every heartbeat produces a wave of blood that causes pulsations through the arteries, this means, pulse frequencyis equalto the frequency of heart ventricle contractions. Normally pulse rate is equalto heart rate. The pulsecan be palpated through the nerves in the fingertips if the fingersare placed over one of the large arteries that lies close to the skin, especially if the artery runs across a bone and has very little soft tissue around it. Depending on the measuring location, there is peripheral and the central pulse. Peripheral pulse ismeasured in the periphery of the body. Central, apical pulse is located over the apex of the heart (the bottom point of the heart). 51 5.1.1 Pulse assessment Characteristics of the pulse, including rate (frequency), rhythm and volume are indicators of circulatory status, provide information on the regularity of heart beat and an indication of the strength of heart contraction, about the effectiveness of the heart as a pump and the adequacy of peripheral blood flow. Heart rate/pulse frequency Heart rate is the number of times a person\'s heart beats per minute. Heart rate can be affected by following factors: Age. Heart rate slows down with age. Gender. After puberty resting heart rate of males generally is slightly slower than the heart rate of females. Physical activity. Physical activity increases the heart rate because of the in- crease in the metabolic rate and the increased demand for oxygen and nutrients at the cellular level, strokevolume and cardiac output increase. Increase in heart rate in athletes may be lower than in the averageadult because of larger cardiac size, strength, efficiency and endurance. Emotional status (stress, fear, anxiety, worry, excitement). Emotions stimu- late sympathetic nervous system, resulting in vasoconstriction (narrowing of peripheral blood vessels) and an increase in the metabolic rate, force of cardiac activity(contractions) and heart rate. Body temperature. Fever increases heart rate to compensate for the decreased blood pressure associated with increased basal metabolic rate and vasodilatation (extension of peripheral blood vessels). Heart rate rises about 10 beats for every 0.56 °C increase in body temperature. Lower body temperature decreases the heart rate because the basal metabolic rate slows and because of vasoconstriction. Blood volume. In case of increased blood volume hypervolemia because of fluid volume excess or by excess intravenous fluids, heart rate may increase, in case of decreased blood volume- hypovolemia, heart rate increases to transport more oxygen to body cells (e.g. at the bleeding, dehydration). Drugs. Some kinds of drugs decrease the heart rate (e.g. cardiotonics, antihy- pertensives, opioid), others increase heart rate (e.g. atropine, adrenalin- epine- Pathological proceses.Any condition that influences cardiac, respiratory or neurological functioning may increase or decrease the heart rate or make it irregular(e.g. pulmonary diseases, cardiovascular diseases). The following values are distinguished in the pulse rate measurement: Normocardia is the normal (physiological) resting heart rate, in healthy adults it ranges from 60 to 100 beats per minute (bpm), the average rate is 70- 80 bpm. Tachycardia is a resting heart rate above 100 bpm in adults. Bradycardia IS a resting heart rate below 60 bpm in adults. The range of physiological values of the pulse frequency according to age IS shown in Table 5. 52 Age infant(\