Med Sur Lab

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AssessingApicalPulse-checklist.pdf

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Mosby: Mosby's Nursing Video Skills Student _________________________________________ Date ___________________ Instructor _______________________________________ Date ___________________

PERFORMANCE CHECKLIST FOR ASSESSING APICAL PULSE

S U NP Comments

1. Verified health care provider’s orders.

2. Gathered necessary equipment and supplies.

3. Performed hand hygiene.

4. Provided patient’s privacy.

5. Introduced self to patient and family.

6. Identified patient using two identifiers.

7. Assessed for factors that can affect apical pulse

rate and rhythm.

8. Used gloves if necessary.

9. Helped patient into appropriate position.

10. Located PMI properly.

11. Slid fingers down to ICS, then to the fifth

intercostals space, then over to the left

midclavicular line.

12. Felt PMI as a light tap reflecting apex of the

heart.

13. Located PMI if not where expected.

14. Warmed diaphragm of stethoscope in palm of

hand, cleaned with alcohol, allowed to dry.

15. Placed diaphragm over PMI, auscultated for

normal S1 and S2 sounds.

16. Looked at watch once sounds were heard

with regularity, took pulse properly.

17. Replaced patient’s gown and bed linen

helped patient to comfortable position,

discussed findings as appropriate.

18. Cleaned earpieces and diaphragm with

alcohol after each use, discarded swab

appropriately.

19. Placed personal items within reach.

20. Placed call light within reach, ensured patient

knew how to use it.

21. Raised top side rails and lowered bed to

ensure patient safety.

22. Disposed of used supplies and equipment, left

patient’s room tidy.

23. Removed and disposed of gloves if worn,

performed hand hygiene.

24. Compared patient’s apical pulse rate and

rhythm with baseline and acceptable range.

25. Documented and reported patient’s response

and outcomes.