Apex Beat 242z55
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Ayu Sulaini_Apex Beat
1
ASSESSMENT OF APEX BEAT
Ayu Sulaini_Apex Beat
2
LEARNING OUTCOME At the end one hour lecture, the students must be able to: 1. Define apex beat. 2. List the variation of heart beat by age. 3. State the purpose of assessment of apex beat. 4. State the location of assessment of apex beat. 5. State the factor affecting for heart beat.
Ayu Sulaini_Apex Beat
3
LEARNING OUTCOME 5. Explains the nursing management in assessment of apex beat. 6. Demonstrate the technique of assessment of apex beat 7. Appreciate the knowledge of assessment of apex beat.
Ayu Sulaini_Apex Beat
4
DEFINITION
Ayu Sulaini_Apex Beat
5
VARIATIONS OF HEART BEAT BY AGE AGE
HEAR T RATE AVERAGE (BPM)
Newborn
130 (80-180)
1 year
120 (80-140)
5-8 years
100 (75-120)
10 years
70 (50-90)
Teen
75 (50-90)
Adult
80 (60-100)
Older adult
70 (60-100) Ayu Sulaini_Apex Beat
6
PURPOSE To obtain the heart rate of newborns, infants, and children 2 to 3 years old or of an adult with an irregular peripheral pulse
To establish baseline data for subsequent evaluation To determine whether the cardiac rate is within normal range and the rhythm is regular To monitor clients with cardiac, pulmonary, or renal disease and those receiving medication to improve heart action. Ayu Sulaini_Apex Beat
7
AGE PATHOLOGY
POSITION CHANGES
STRESS
GENDER
FACTOR AFFECTING HEART BEAT HYPOVOLEMIA
EXERCISE
FEVER
MEDICATION
Ayu Sulaini_Apex Beat
8
AGE AGE
FACTOR AFFECTING HEART BEAT
Ayu Sulaini_Apex Beat
9
LOCATION RIGHT MID-CLAVICULAR LINE
LEFT
5TH intercostal space
INTERCOSTAL SPACE
1 cm medial to the mid-clavicular line
Ayu Sulaini_Apex Beat
10
Ayu Sulaini_Apex Beat
11
PURPOSE To obtain the heart rate of newborns, infants, and children 2 to 3 years old or of an adult with an irregular peripheral pulse
To establish baseline data for subsequent evaluation To determine whether the cardiac rate is within normal range and the rhythm is regular To monitor clients with cardiac, pulmonary, or renal disease and those receiving medication to improve heart action. Ayu Sulaini_Apex Beat
12
Ayu Sulaini_Apex Beat
13
ASSESSMENT ACTION
RATIONALE
1. Patient condition 2. Clinical sign of cardiovascular alterations (dyspnea, pallor, cyanosis)
To know the reason for any abnormalities
3. Factors that may alter heart rate (medication) 4. Know the previous heart rate before the actual procedure
As a data baseline
5. Environment
Provide adequate work space Ayu Sulaini_Apex Beat
14
PLANNING
Watch with a second hand or indicator
Stethoscope Antiseptic wipe Ayu Sulaini_Apex Beat
15
IMPLEMENTATION ACTION
RATIONALE
1. Greet client and introduce self. Explain Get the client cooperate and to reduce to the client regarding the procedure. patient anxiety. 2. Perform hand hygiene.
To minimize the organism transmission.
3. Provide for client privacy.
Maintain the client self-image
4. Use antiseptic wipes to clean the earpieces and diaphragm.
The diaphragm needs to be cleaned and disinfected, to minimize the organism transmission.
5. Standing on the side of the client
Avoid expose other part in order to maintain the privacy of the client.
Ayu Sulaini_Apex Beat
16
IMPLEMENTATION ACTION
RATIONALE
6. Locate the apical pulse by: •Slide your index finger just to the left of the sternum, and palpate the second intercostal space. •Place your middle or next finger in the third intercostal space. Continue palpating downward until you locate the fifth intercostal space. •Move your index finger laterally along the fifth intercostal space toward the mid-clavicle line (MCL). 7. Place the diaphragm of the stethoscope over the apical impulse and listen for the normal heart sounds
To obtain the accurate result
To listen to heart sounds
Ayu Sulaini_Apex Beat
17
IMPLEMENTATION ACTION
RATIONALE
8. Count the heartbeats for 1 minute
Provide a more accurate assessment
9. Comfort the client
Ensure comfort
10. Inform the client result 11. Document in the client record
As a documentation
Ayu Sulaini_Apex Beat
18
EVALUATION ACTION
RATIONALE
1. Relate the result to baseline data and health status
Detect early abnormalities
2. Report to the primary provider any abnormal findings.
Early treatment, to prevent further complication.
Ayu Sulaini_Apex Beat
19
DEMONSTRATION
Ayu Sulaini_Apex Beat
20
CONCLUSION 1. 2. 3. 4. 5. 5.
Define apex beat. List the variation of heart beat by age. State the purpose of assessment of apex beat. State the location of assessment of apex beat. State the factor affecting for heart beat. Explains the nursing management in assessment of apex beat. 6. Demonstrate the technique of assessment of apex beat 7. Appreciate the knowledge of assessment of apex beat. Ayu Sulaini_Apex Beat
21
REFERENCES Berman, A., Snyder, S. J., Kozier, B., & Erb, G. (2008). Kozier & Erb’s Fundamental of nursing: Concepts, process and practice (8th ed.). New Jersey: Prentice Hall. Rasnah Abd. Rahman & Salizar Mohamed Ludin (2005). Prosedur kejururawatan menggunakan proses kejururawatan. Selangor,Malaysia:Prentice Hall Warkman, B., & Bennett, C, L. (2003). Key nursing skills. London: Whurr Publisher.
Ayu Sulaini_Apex Beat
22
THANK YOU….
Ayu Sulaini_Apex Beat
23
1
ASSESSMENT OF APEX BEAT
Ayu Sulaini_Apex Beat
2
LEARNING OUTCOME At the end one hour lecture, the students must be able to: 1. Define apex beat. 2. List the variation of heart beat by age. 3. State the purpose of assessment of apex beat. 4. State the location of assessment of apex beat. 5. State the factor affecting for heart beat.
Ayu Sulaini_Apex Beat
3
LEARNING OUTCOME 5. Explains the nursing management in assessment of apex beat. 6. Demonstrate the technique of assessment of apex beat 7. Appreciate the knowledge of assessment of apex beat.
Ayu Sulaini_Apex Beat
4
DEFINITION
Ayu Sulaini_Apex Beat
5
VARIATIONS OF HEART BEAT BY AGE AGE
HEAR T RATE AVERAGE (BPM)
Newborn
130 (80-180)
1 year
120 (80-140)
5-8 years
100 (75-120)
10 years
70 (50-90)
Teen
75 (50-90)
Adult
80 (60-100)
Older adult
70 (60-100) Ayu Sulaini_Apex Beat
6
PURPOSE To obtain the heart rate of newborns, infants, and children 2 to 3 years old or of an adult with an irregular peripheral pulse
To establish baseline data for subsequent evaluation To determine whether the cardiac rate is within normal range and the rhythm is regular To monitor clients with cardiac, pulmonary, or renal disease and those receiving medication to improve heart action. Ayu Sulaini_Apex Beat
7
AGE PATHOLOGY
POSITION CHANGES
STRESS
GENDER
FACTOR AFFECTING HEART BEAT HYPOVOLEMIA
EXERCISE
FEVER
MEDICATION
Ayu Sulaini_Apex Beat
8
AGE AGE
FACTOR AFFECTING HEART BEAT
Ayu Sulaini_Apex Beat
9
LOCATION RIGHT MID-CLAVICULAR LINE
LEFT
5TH intercostal space
INTERCOSTAL SPACE
1 cm medial to the mid-clavicular line
Ayu Sulaini_Apex Beat
10
Ayu Sulaini_Apex Beat
11
PURPOSE To obtain the heart rate of newborns, infants, and children 2 to 3 years old or of an adult with an irregular peripheral pulse
To establish baseline data for subsequent evaluation To determine whether the cardiac rate is within normal range and the rhythm is regular To monitor clients with cardiac, pulmonary, or renal disease and those receiving medication to improve heart action. Ayu Sulaini_Apex Beat
12
Ayu Sulaini_Apex Beat
13
ASSESSMENT ACTION
RATIONALE
1. Patient condition 2. Clinical sign of cardiovascular alterations (dyspnea, pallor, cyanosis)
To know the reason for any abnormalities
3. Factors that may alter heart rate (medication) 4. Know the previous heart rate before the actual procedure
As a data baseline
5. Environment
Provide adequate work space Ayu Sulaini_Apex Beat
14
PLANNING
Watch with a second hand or indicator
Stethoscope Antiseptic wipe Ayu Sulaini_Apex Beat
15
IMPLEMENTATION ACTION
RATIONALE
1. Greet client and introduce self. Explain Get the client cooperate and to reduce to the client regarding the procedure. patient anxiety. 2. Perform hand hygiene.
To minimize the organism transmission.
3. Provide for client privacy.
Maintain the client self-image
4. Use antiseptic wipes to clean the earpieces and diaphragm.
The diaphragm needs to be cleaned and disinfected, to minimize the organism transmission.
5. Standing on the side of the client
Avoid expose other part in order to maintain the privacy of the client.
Ayu Sulaini_Apex Beat
16
IMPLEMENTATION ACTION
RATIONALE
6. Locate the apical pulse by: •Slide your index finger just to the left of the sternum, and palpate the second intercostal space. •Place your middle or next finger in the third intercostal space. Continue palpating downward until you locate the fifth intercostal space. •Move your index finger laterally along the fifth intercostal space toward the mid-clavicle line (MCL). 7. Place the diaphragm of the stethoscope over the apical impulse and listen for the normal heart sounds
To obtain the accurate result
To listen to heart sounds
Ayu Sulaini_Apex Beat
17
IMPLEMENTATION ACTION
RATIONALE
8. Count the heartbeats for 1 minute
Provide a more accurate assessment
9. Comfort the client
Ensure comfort
10. Inform the client result 11. Document in the client record
As a documentation
Ayu Sulaini_Apex Beat
18
EVALUATION ACTION
RATIONALE
1. Relate the result to baseline data and health status
Detect early abnormalities
2. Report to the primary provider any abnormal findings.
Early treatment, to prevent further complication.
Ayu Sulaini_Apex Beat
19
DEMONSTRATION
Ayu Sulaini_Apex Beat
20
CONCLUSION 1. 2. 3. 4. 5. 5.
Define apex beat. List the variation of heart beat by age. State the purpose of assessment of apex beat. State the location of assessment of apex beat. State the factor affecting for heart beat. Explains the nursing management in assessment of apex beat. 6. Demonstrate the technique of assessment of apex beat 7. Appreciate the knowledge of assessment of apex beat. Ayu Sulaini_Apex Beat
21
REFERENCES Berman, A., Snyder, S. J., Kozier, B., & Erb, G. (2008). Kozier & Erb’s Fundamental of nursing: Concepts, process and practice (8th ed.). New Jersey: Prentice Hall. Rasnah Abd. Rahman & Salizar Mohamed Ludin (2005). Prosedur kejururawatan menggunakan proses kejururawatan. Selangor,Malaysia:Prentice Hall Warkman, B., & Bennett, C, L. (2003). Key nursing skills. London: Whurr Publisher.
Ayu Sulaini_Apex Beat
22
THANK YOU….
Ayu Sulaini_Apex Beat
23
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