Measuring Pulse and Respiration

Pulse and Respiration

3 Locations a Pulse Can Be Taken

• Radial Pulse: This is probably what we’re most familiar with when visiting the doctor’s office. Take two fingers, preferably the 2nd and 3rd finger, and place them in the groove in the wrist that lies beneath the thumb. Move your fingers back and forth gently until you can feel a slight pulsation – this is the pulse of the radial artery which delivers blood to the hand. Don’t press too hard, or else you’ll just feel the blood flowing through your fingers! You can even use your thumb.
• Carotid Pulse: The carotid arteries supply blood to the head and neck. You can feel the pulse of the common carotid artery by taking the same two finger and running them alongside the outer edge of your trachea (windpipe). This pulse may be easier to find that of the radial artery. Since the carotid arteries supply a lot of the blood to the brain, it’s important not to press on both of them at the same time!
• Femoral pulse: The femoral artery carries blood to parts of the leg. Aside from the carotid artery, it is another common site to check for a pulse in an emergency situation. Think of an imaginary line running from your hip to the groin. The approximate superficial location of the femoral artery lies 2/3 of the way in from the hip.

Anytime you are going to provide care for your clients, you will need to follow hand washing procedures.  You will then greet your client and tell him or her why you are there.  Explain any procedures you are going to perform.  Additionally, you should always check a client’s identity band to ensure you are working with the correct client.

Lift your client’s hand and place your index and middle finger by their thumb.  Move your fingers to the hallow of their wrist so that you can take their pulse.  You will need to apply some gentle pressure until you can feel their pulse.  You can count their number of beats for 30 seconds.  To calculate their pulse rate per minute, simply multiply that number by two.  If you have a client with an irregular heart rate, you should count their pulse for an entire minute.  Their pulse rate should be recorded in their chart.

Once again, you will want to wash your hands after working with a client.

There are some signs to look for if you think that a client might have an irregular heart rate.  Ideally an adult’s pulse rate will be between 60 and 80 beats every minute.  Some clients will have a lower heart rate as the result of medication they are taking.  Individuals who are at rest or who are physically fit can have lower heart rates as well.

Clients who are under stress, can have an increased heart rate.  The same is true of someone who has had a recent intake of caffeine.  Illegal drugs can also increase the heart rate.  Of course some medications will actually increase a client’s heart rate.

You will typically notice an increased heart rate in a client with an infection or a client who has a fever.  The same is true of client’s with bleeding that is not controlled.

Any concerns about a client’s heart rate should be reported to the appropriate person as instructed in your list of duties.

Counting and Recording Clients Respiration.

When working as a nursing aide, you will also need to measure a client’s respiration.  Do not tell the client that you are measuring respiration so that they do not alter their breathing.  You can usually take a client’s respirations after counting their pulse rate.  Wash your hands before working with a client.  Respirations are a measure of the amount of times a client is breathing each minute.

Each times that a person’s chest rises and falls, you will note that they have taken one breath.  You can begin counting the number of times a client breathes while timing one minute.  As you watch the client breath, you should also pay attention to how deeply they are breathing.  Pay careful attention if you notice they are using additional muscles (than usual) to take a breath.  You will write down their respiration rate in their chart.

An individual should take between 12 and 18 breaths each minute.  Of course, there are various things than can have an impact on a client’s respiration.  Some clients will breathe at a slower rate if they are resting.  The same is true for individuals who are laying on their back while you are counting respiration.

If a client is using narcotics, their respirations might be a little bit slower.  Narcotics can slow down the respiration rate.

Sometimes an increase in respirations will be noted.  This often occurs if a client is feeling very stressed.  An increase in respiration is not uncommon in a client who has recently had increased activity.  The same is true of clients who are experiencing pain.  If a client has an infection or an increased body temperature, they are likely to have a faster respiration rate as well.

There are other factors that can influence respirations.  Some examples include clients who have suffered from a heart attack, clients who have actually had an overload of fluids and , of course, clients who are experiencing some type of respiratory distress.  You should report any concerns pertaining to respiration to the proper superior.