Wh en the rhythm is irregular, the rate should be evaluated by cardiac aus- Irregular rhythms include atrial fi-
cultation, because beats that occur earlier than others may not be detected brillation and atrial or ventricular peripherally and the heart rate can thus be seriously underestimated. premature contractions.
Rhythm. To begin your assessment of rhythm, feel the radial pulse. If there are any irregularities, check the rhythm again by listening with your stethoscope at the cardiac apex. Is the rhythm regular or irregular? If irregular, try to identify a pattern: (1) Do early beats appear in a basically regular rhythm? (2) Does the irregularity vary consistently with respiration? (3) Is the rhythm totally irregular?
Palpation of an irregularly irregular rhythm reliably indicates atrial fibrillation. For all other irregular patterns, an ECG is needed to identify the arrhythmia.
See Table 3-10, Selected Heart
Rates and Rhythms (p._) and
Table 3-11, Selected Irregular Rhythms (p._).
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Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...