Figure 4-3. Electronic vital signs monitor.
b. Measuring an Apical Pulse.
(1) Warm the stethoscope in your hands. A cold stethoscope may surprise
the patient and alter the pulse rate.
(2) Place the stethoscope at the apex (pointed end) of the heart, in the left
center of the chest, just below the nipple. The pulse can usually be heard best at the
Count the pulse for one full minute.
c. Measuring the Apical-Radial Pulse.
(1) If the apical-radial (A-R) pulse is ordered by the physician, two nurses
carry out the procedure together.
(2) Using the same watch, one nurse counts the patient's apical pulse for 1
minute while the other nurse counts the radial pulse for 1 minute. One nurse gives the
signal to start counting, and both start at the same time. The two figures are identified and
charted (A-R pulse 76/72, for example). Normally, these two readings should be the
same. If there is a difference, it is called the pulse deficit.
NOTE: An apical pulse will never be lower than the radial pulse.