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Measuring Radial Pulse

The radial pulse measurement assesses heart rate and rhythm, providing critical information about a resident's cardiovascular status.

12 steps·4 evaluator checkpoints·5 common mistakes

1Step-by-Step Procedure

1
Gather equipment: watch with a second hand (or digital timer), pen, and paper.
2
Wash hands.
3
Identify the resident and explain the procedure.
4
Assist the resident to a comfortable sitting or lying position with the arm resting at heart level, palm up.
5
Locate the radial pulse on the thumb side of the inner wrist using the pads of your index and middle fingers — never the thumb (your thumb has its own pulse).
6
Apply gentle, firm pressure until you can feel the pulse clearly.
7
Note the time on your watch and begin counting the pulse beats for a full 60 seconds.
8
While counting, assess the rhythm (regular or irregular) and strength (strong, weak, bounding, thready).
9
If the rhythm is irregular, always count for a full 60 seconds.
10
Record the rate per minute, rhythm, and strength.
11
Lower the resident's arm gently.
12
Wash hands and report any abnormal findings to the nurse.

⚠
Using the thumb to count the pulse — your thumb has a pulse that will confuse the count.
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Counting for only 30 seconds and doubling — always count the full 60 seconds.
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Pressing too hard and obliterating the pulse, or too lightly to feel it.
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Forgetting to note rhythm and strength, not just the rate.
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Not resting the resident's arm at heart level before counting.

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Use your index and middle fingertips — feel for a regular tap before you start counting.
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Count for the full minute; do not estimate or multiply a 30-second count.
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Normal resting pulse is 60–100 bpm; report anything outside this range.
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If you lose count, stop, reposition your fingers, and start again.

Also study the written exam topics

Physical Care Skills makes up 45% of the written exam — the same procedures you just reviewed will appear as multiple-choice questions.

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