The absence of which pulse may not be a significant finding when a patient is admitted to the hospital?
A. Apical
B. Radial
C. Pedal
D. Femoral
Correct Answer: C. Pedal
Because the pedal pulse cannot be detected in 10% to 20% of the population, its absence is not necessarily a significant finding. However, the presence or absence of the pedal pulse should be documented upon admission so that changes can be identified during the hospital stay. Absent peripheral pulses may be indicative of peripheral vascular disease (PVD). PVD may be caused by atherosclerosis, which can be complicated by an occluding thrombus or embolus. This may be life-threatening and may cause the loss of a limb.
Option A: Apical pulse rate is indicated during some assessments, such as when conducting a cardiovascular assessment and when a client is taking certain cardiac medications (e.g., digoxin). Sometimes the apical pulse is auscultated pre and post medication administration. It is also a best practice to assess apical pulse in infants and children up to five years of age because radial pulses are difficult to palpate and count in this population.
Option B: Examiners frequently evaluate the radial artery during a routine examination of adults, due to the unobtrusive position required to palpate it and it’s easy accessibility in various types of clothing. Like other distal peripheral pulses (such as those in the feet) it also may be quicker to show signs of pathology. Palpation is at the anterior wrist just proximal to the base of the thumb.
Option D: The femoral pulse may be the most sensitive in assessing for septic shock and is routinely checked during resuscitation. It is palpated distally to the inguinal ligament at a point less than halfway from the pubis to the anterior superior iliac spine.