Nursing & Healthcare Programs

Measuring the Radial Pulse

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.

How to Measure the Radial Pulse

  1. Perform hand hygiene and introduce yourself to the patient. Close the curtain or door to protect patient privacy.
  2. Ensure that the patient is prepared for the assessment:
    • Wait five to ten minutes after patient activity.
    • Wait 15 minutes after the patient has smoked or consumed caffeine.
    • The patient should be calm.
  3. Position the patient for accurate measurement of the radial pulse.
    • The patient should be sitting or lying supine.
    • If lying, the patient’s arms should be relaxed along the side of their body or across their lower chest or abdomen.
    • If sitting, the patient’s elbow should be bent at 90 degrees and the lower arm should be supported by the nurse or the arm of a chair.
    • The wrist should be straight with the palm of the hand facing down.
  4. Gently place the first two fingers of your hand over the groove on the thumb side of the patient’s inner wrist. Gently bend or straighten the patient’s wrist until you feel the pulse. You may need to adjust the pressure of your fingers, as it is easy to press too hard and close off the artery.
  5. Observe the feel of the pulse. Is it barely there? Is it practically leaping out of the patient’s arm? Are there stutters to it?
  6. Look at a clock with a second hand or a digital clock with seconds displayed. Note the second and begin counting the pulse for one full minute.
  7. Measure the radial pulse on the other wrist. Pay attention to differences between the two sides.
    • Measurement of both radial pulses may not be required by institutional or unit policy, but is good practice for new patients or if abnormalities are detected on the first side measured.
  8. Assist the patient back to a more comfortable position.
  9. Perform hand hygiene.
  10. Document the pulse rate and pattern in the patient’s record and inform the nurse of any rate or rhythm abnormality or difference between the two arms or if there is a significant change from the previous measurement per institutional or unit protocol.

Amanda R. McDaniel, MS, BSN, RN

References

Fetzer, S. J. (2014). Vital signs and physical assessment. In A. G. Perry, P. A. Potter, and W. R. Ostendorf (Eds), Clinical nursing skills & techniques (8th ed., pp. 77-80). St. Louis, MO: Mosby Elsevier.

More Resources

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Dressing and Undressing a Patient

Patients who have suffered a stroke or have weakness or injury to one side of their body may struggle with dressing and undressing. In order to help these patients regain their strength and independence, it is important that the nurse’s aide only assist them as needed. The nurse’s aide may need to teach patients how to dress and undress safely with their limitations.

Sim’s Position

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Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

Applying Elastic Support Hose

Elastic stockings are worn to prevent deep vein thrombosis (DVT) and reduce the pooling of blood in vessels. Many hospitals and care facilities use elastic stockings in patients with reduced mobility, such as surgical patients and/or the elderly. There are a few risks in wearing elastic stockings; however, these risks can be prevented with proper application and care.