Measure and Record Pulse
Care Plan: Patient will be lying in bed for skill. Take the patient’s radial pulse, measured at the wrist, for one full minute and record your readings.
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Do I have to count for one full minute?
Yes, for the exam the pulse must be measured for one full minute. Although in many clinical settings healthcare workers may be permitted to count for 15 seconds and multiply by four, or 30 seconds and multiply by two, this is not permitted on the exam. When evaluating the pulse, the CNA is not just counting the number of pulses felt underneath the fingers. It is just as important for the CNA to also evaluate the quality of the pulse. Counting for less than one minute may reduce the accuracy of the pulse reading and does not allow the CNA sufficient time to evaluate the quality of the pulse.
Where were the patient be during this skill?
Currently, the state of Florida requires that the patient for this skill be positioned in a bed. This keeps the testing uniform among all testing centers. However, CNAs should be aware of how to perform the skill on a patient in a variety of positions.
Do I have to record the pulse on the documentation sheet?
All pulse readings must be documented on the documentation sheet provided by the evaluator. The student should document the results after performing their closing and washing their hands.
Why do I have to wash my hands before documenting the reading?
Anything that goes home with you at the end of the day (like your keys, pens, cell phone or lunch box) can be contaminated by your unclean hands. Those items can then spread pathogens (disease causing organisms) into your home. You should make it a habit to only touch these items with clean hands.
Do I have to tell the patient what I am doing every step of the way?
By keeping the patient informed of every step that you are going to be performing, the patient will feel more like a partner in their healthcare. This reduces anxiety and increases patient compliance. By letting the patient know that you will be counting their pulse for one full minute, and the patient should remain quiet during this time, the patient is less likely to interrupt you in the middle of your reading.
Why don’t I wear gloves for this skill?
Gloves should be worn only when there is a potential to be exposed to blood and body fluids, touching personal skin or touching non-intact skin. They should not be worn for routine skin contact. Gloves will make it more difficult to measure the pulse.
Why can't I measure the pulse and respiration together?
The care plan will define what skills are required for you to perform on each individual patient. CNA’s are not allowed to deviate from the care plan. For the exam, the care plan will specifically instruct you to obtain a pulse on the patient.
Why do I have to count the pulse twice for the state exam?
For the exam, your accuracy will need to be evaluated by BOTH proctors. Since the care plan specifies that we must count the radial pulse, measured at the wrist, the proctors must comply to the same protocol. Therefore, this skill must be done twice (once with each proctor). You will only need to do the opening and closing once, however.