Presentation about skills of nursing

1. Prepared by MS.c . : Ayoub A.Abdulmajeed
University of Duhok
Theoretical Lec. Second lectures
2022-2023

2. Pulse/heart rate is the wave of blood in the artery created by contraction of the left
ventricle during a cardiac cycle .
• The pulse rate is a measurement of the heart rate, or the number of times the heart
beats per minute.
Pulse
• Normal pulse rate range for an adult is between 60-100 beats per
minute.
• A well-trained athlete may have a resting heart rate of 40 to 60 beats
per minute, according to the American Heart Association (AHA).

3. • To check abnormalities in rate, rhythm and volume
• To monitor any changes in health status of the patient
• To assess response of heart to cardiac medications, activity, blood volume
and gas exchange
• To check the peripheral circulation
• To determine number of heart beat per minute.
Purposes of taking pulse

4. Tachycardia: When the resting pulse rate increases to more than
100 beats per minute in an adult ,is called tachycardia.
Bradycardia: A pulse rate of less than 60 beats per minute is called
bradycardia.
Parameters of Pulses

5. Peripheral pulses:
That can be felt at the periphery of the body by palpating an artery over a bony
prominence. Examples are carotid, radial pulses.
Apical pulses:
which is a central pulse located on the apex of the heart that is monitored using
a stethoscope
Types of Pulse rate

6. The pulse is:
• The beat of the heart felt at an artery as a wave of blood passes through
the artery
• More easily felt in arteries that come close to the skin and can be gently
pressed against a bone
• The pulse should be the same in all pulse sites on the body
Taking pulse

7. • Age
• Blood pressure
• Sex
• Drugs (medications)
• Exercise/activity
• Disease conditions
• Acute pain and anxiety
• Emotions ,Anger ,excitement
• Fever Hypovolemia/hemorrhage"
Factors affecting the pulse
The pulse rate is affected by many factors

8. Pulse sites

9. We usually count a pulse for 30 seconds and multiply the number times 2 to get the pulse
rate for 1 minute
We note the rhythm (pattern) of the heart beat
if the heart beat is irregular we count the pulse for a full
minute we also observe the force (strength) of the
heartbeat. Does the pulse feel :
Strong, full , bounding ,Weak , Thread
Counting a pulse

10. 1. Pulse rate: It is the number of pulse beats per minute. Normal pulse rate in adults
varies from 60 to 100 beats per minute.
2. Rhythm or regularity: It is the time interval between pulse beats. Normally the
time intervals between pulse beats are equal or regular.
3. Tension: It is degree of compressibility and depends upon the resistance of the
wall of the artery.
4. Strength/volume: It is the fullness of artery. It is force of blood felt at each beat.
Characteristics of pulse

11. • Most common site used for taking a pulse.
• Can be taken without disturbing or exposing the person.
• Place the first two or three fingers of one hand against the radial
artery.
• The radial artery is on the thumb side of the wrist.
• Do not use your thumb to take a person’s pulse.
• Use gentle pressure.
• Count the pulse for 30 seconds and multiply by two.
Radial pulse

12. • Always clean the earpieces of the stethoscope with alcohol
before and after use.
• Warm the diaphragm in your hand before placing it on the
person
• Hold the diaphragm in place over the artery
• Do not let the tubing strike against anything while the
stethoscope is being used
Using A stethoscope

13. • Taken with a stethoscope
• Counted by placing the stethoscope over the heart , counted for one full minute
• The heart beat normally sounds like a lub-dub. Each lub-dub is counted as one
heartbeat. (Do not count the lub as one heartbeat and the dub as another.
• The apical pulse is taken on patients who have heart disease , an irregular pulse
rate, or take medications that can affect the heart.
Apical pulse

14. pulse ranges for different ages

16. • Respirations rate should be assessed when the client is relaxed,
because exercise affects respirations
• The rate, depth, rhythm, and quality and effectiveness of respirations
should be assessed.
• The respiratory rate is normally described in breaths per minute.
• Count respirations right after taking a pulse Keep your fingers or
stethoscope over the pulse site to count respirations, watch the chest
rise and fall

17. One respiration consists of one inspiration and one expiration
• The chest rises during inspiration (breathing in) and falls during expiration
(breathing out)
• Count for 30 seconds and multiply x 2
• Do not let the person know you are counting their respirations
• Count after taking the pulse – keep your fingers on the pulse site
• Normal respiratory rate for adult is 12 – 20 breaths per min.

18. Rate
• Tachypnea—quick, shallow breaths
• Bradypnea—abnormally slow breathing
• Apnea—cessation of breathing
Volume
• Hyperventilation—Hyperventilation is rapid or deep breathing, usually caused by
anxiety or panic.characterized by rapid and deep breaths
• Hypoventilation—underexpansion of the lungs, characterized by shallow
respirations
Breathing patterns

19. Abnormal Respirations
Tachypnea – respiratory rate over 20 (Rapid, shallow respirations-- < 25/minute)
Bradypnea – respiratory rate below 12 (Slow respiratory rate- > 10/minute)
Dyspnea – shortness of breath – difficulty in breathing .
Apnea – no breathing (Absence of respirations )
Hyperventilation – fast and deep respirations
Hypoventilation – slow and shallow respirations
Orthopnea: ability to breathe only in upright sitting or standing positions(Difficulty
breathing in all positions except sitting or standing)

20. • To monitor abnormal respirations and respiratory patterns and identify changes
• To monitor respirations before or following the administration of a general anesthetic or any
medication that influences respirations
• To monitor clients at risk for respiratory alterations (e.g., those with fever, pain, acute
anxiety, chronic obstructive pulmonary disease, asthma, respiratory infection, pulmonary
edema or emboli, chest trauma ,brain stem injury)
Purposes

21. Pain assessment
• Pain means to ache, hurt, or be sore.
• Pain is a warning from the body.
• Types of pain
• Acute pain – felt suddenly from an injury, disease, trauma, or surgery
• Chronic pain – lasts longer than 6 months. Pain can be constant or occur
on and off.
• Radiating pain – felt at the site of tissue damage and in nearby areas.
• Phantom pain – felt in a body part that is no longer there.

22. • Location – Where is the pain?
• Onset and duration – When did the pain start?
• Intensity – Rate the pain on a scale of 1 to 10, with 10 as the most
severe
• Description – Can you use words to describe the pain?
• Factors causing pain – What were you doing when the pain started?
• Vital signs – Take the person’s vital signs when they complain of pain.
Other signs and symptom
• Body responses - ↑ vital signs, nausea, pale skin, sweating, vomiting
• Behaviors – crying, groaning, holding affected body part, irritability,
restlessness
Signs and symptoms