Measure and Record Radial Pulse
These are the basic steps for measure and record a resident’s radial pulse. In-depth step by step directions can be found in our CNA Skills Study Guide, available on this website.
- Opening and wash hands
- Locate pulse on thumb side of patient’s wrist (do not use your thumb)
- Count thumps you feel under your fingers for time specified on care plan
- Perform closing and wash hands
- Document reading
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Count the pulse for a full 60 seconds!
This care plan instructs us to count for one full minute, and that is what we will be graded on! Every patient is different. Each one will have different needs. In some settings, for some patients, you can count for 15 seconds and multiply by 4 (often done in a clinical setting). But for some reason, the RN who has assessed this patient wants us to count for one full minute instead of 15 seconds. Maybe the patient is on a new medication. They might have an irregular heart beat. Or maybe they just engaged in a specific activity that affects their heart rate. We don’t need to know WHY the RN wants us to count for one full minute…it is enough to know that right now, right here, for this patient, that is what we have to do! So, follow the care plan and count for one full minute.
Radial Pulse ONLY!
Don’t get fancy here and pull out your stethoscope, thinking you are going to show the evaluator how smart you are and listen to the patient’s heart beat to get the pulse (called an apical pulse). That is NOT what the care plan told you to do! You will fail if you don’t follow the care plan exactly. So take the radial pulse, measured at the wrist, just like the care plan says!
In Florida, you have to count twice…
Florida has 2 evaluators. Each evaluator has to have the chance to grade your accuracy. So, you will count with the first evaluator, record your reading and then count with the second evaluator. This is the only skill that must be done twice during the test.
Don’t forget to write it down!
If you measure something in healthcare, it is in your head…no where else…until you write it down. Since you are measuring something for the nurse, that isn’t much help if it is only in your head! You must write it down so that others can use that information! If you forget to write it down, it’s like it wasn’t done because we still don’t have the information to make medical decisions!
Why is finding the radial pulse on the left wrist much harder, I’ve found? And please any tips on getting it as accurate as possible?
This basic skill I’ve found to be the most challenging!
Thank you very much, AS
You can use an overhand hold or an underhand hold (think: guitar) when locating the pulse with your fingertips, depending on what side of the patient you are on and what is most comfortable. Don’t stare at the clock, because you will subconsciously count the seconds instead of the pulse. Hope this helps!