466 The Nursing Assistant Copyright Goodheart-Willcox Co., Inc. What Is a Pulse? When you take (measure) a pulse, you are feeling or hearing the pressure of blood against the wall of an artery as the heart beats, or contracts and relaxes. Pulse is an important vital sign because it shows how well the cardiovascular system is working. It is particularly important if a resident has a heart or respiratory condition. Pulse Locations There are several locations in which an artery comes close enough to the surface of the skin that you can feel a pulse (Figure 18.16). Arteries that can be felt through bare skin include the temporal, carotid, apical, brachial, radial, femoral, popliteal, and dorsalis pedis arteries. The three pulse locations that are most commonly used are the 1. radial artery 2. apical artery and 3. carotid artery. Using a Temporal Artery Thermometer—Digital (continued) 11. Ensure safety during the procedure. If the resident is in a bed with side rails, raise and secure the rails on the opposite side of the bed from where you will be working. Lower the rail on the side you are working. Best Practice Disposable gloves are worn only if required for infection prevention and control. 12. Position the resident comfortably. 13. Help or have the resident turn so that his forehead faces you. 14. Start the thermometer and wait until it shows it is ready. 15. Place the probe in the middle of the patient’s forehead (Figure 18.15A). Then slowly move the thermometer across the forehead toward the ear, stopping in front of the ear (Figure 18.15B). Figure 18.15 A B 16. Wait until you see or hear the signal that the temperature is complete. 17. Wash your hands or use hand sanitizer to ensure infection control. 18. Record the temperature on a pad, on a form, or in the electronic record. 19. If the resident is in bed, check to be sure the bed wheels are locked. Then reposition the resident and lower the bed. 20. Follow the plan of care to determine if the side rails should be raised or lowered. 21. Clean and store the temporal artery thermometer according to the facility policy. Follow-Up 22. Make sure the resident is comfortable and place the call light and personal items within reach. 23. Conduct a safety check before leaving the room. The room should be clean and free from clutter or spills. 24. Wash your hands or use hand sanitizer before leaving the room. Reporting and Documentation 25. Communicate any specific observations, complications, or unusual responses to the licensed nursing staff. Images courtesy of Wards Forest Media, LLC