Pretending to palpate pulses

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  1. This is a discussion on Pretending to palpate pulses in General Nursing Discussion, part of General Nursing ... I know that nurses are often time crunched and some pulses are often hard to palpate, but... I had...

    by Sep 12, '08
    I know that nurses are often time crunched and some pulses are often hard to palpate, but...
    I had a patient in clinicals who had just had iliac stent placement for PVD, so palpating pulses distal to this stent were vital to the assessment. I informed the nurse that I couldn't feel the politeal and asked if she could check. She comes in and places 2 fingers on the patient's knee and says "Yeah, I can feel it really lightly."



    Now, if my understanding of anatomy is correct- is the politeal not palpated BEHIND the knee???
    I reached over to feel what she claimed to be feeling and she smiled and walked away to document positive pulses. Aarrggg!
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    by nessajune21 Sep 12, '08 8:12 pm
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  2. 15 Comments so far...

  3. Sep 12, '08 by
    Did she even bother to palpate the pedal pulses? Posterior tibial? I hardly ever palpate the popliteal because IMHO, if the patient has a PT and DP pulses then they obviously are getting arterial flow to the extremities.And I've never known the popliteal pulse to be palpated anywhere besides the back of the knee.
    BBFRN, FireStarterRN, Jo Dirt, and 1 other like this.
  4. Sep 12, '08 by
    The patient had a BKA, so this was really the only assessment point for this extremity!
    :uhoh21:
    BBFRN likes this.
  5. Sep 12, '08 by
    Quote from nessajune21
    The patient had a BKA, so this was really the only assessment point for this extremity!
    :uhoh21:

    Oh...:stone
  6. Sep 12, '08 by
    Well, I guess that answers Michigan's question.

    I often have trouble finding distal pulxes, at least, strongly enough to count them. But no, I don't fake finding them. I ask another to assess and expect that they really will.
    BBFRN, nursemary9, romantic, and 3 others like this.
  7. Sep 12, '08 by
    [[/b]
    Quote from nessajune21
    the patient had a bka, so this was really the only assessment point for this extremity!
    :uhoh21:
    omg......hmm....that is just ahuge patient safety issue. i mean that is someones mother, brother, father, sister , child or friend lying there......that patient is somebody special to someone.......and that is just wrong. i hate that you had to witness that...and i hope the patient is ok. i mean those stents can occlude etc etc etc...bad things can happen.
    nursemary9, pagandeva2000, and nessajune21 like this.
  8. Sep 12, '08 by
    Quote from nessajune21
    I know that nurses are often time crunched and some pulses are often hard to palpate, but...
    I had a patient in clinicals who had just had iliac stent placement for PVD, so palpating pulses distal to this stent were vital to the assessment. I informed the nurse that I couldn't feel the politeal and asked if she could check. She comes in and places 2 fingers on the patient's knee and says "Yeah, I can feel it really lightly."



    Now, if my understanding of anatomy is correct- is the politeal not palpated BEHIND the knee???
    I reached over to feel what she claimed to be feeling and she smiled and walked away to document positive pulses. Aarrggg!
    I'm assuming you're a student here (and that it can be intimidating to question a staff nurse's assessment/intervention).... You don't say what happened afterwards other than the staff nurse charted a + popliteal pulse on a site that wasn't correct to assess (and smiled about it.... what was that all about, I wonder?). You also don't mention any assessment of the stump (color/temp)... Anyhoodles, I hope you discussed the whole popliteal thang with the nurse.

    Never be afraid to question! Sometimes the students know more than the nurses!
    BBFRN likes this.
  9. Sep 12, '08 by
    As mentioned above color, blanching, temp, mottling, are all other signs of blood flow status. Not every one is as adept at palpating as another. There have been patients that I have felt a weak pulse and another nurse said they were doppler only (and vice versa). I have had patients where I could feel them half of the time and could only doppler them the other half. The nurse should have used this as a teaching opportunity, and then you probably wouldn't be asking this question. That all goes back to the fact that some nurses are just not teachers. I can always tell the poor nurses that orient with them because they are great at the "tasks" but they are very unsure of their assessment skills ( more so than normal of course as a new nurse...lol)
    RN1989, nursemary9, and nessajune21 like this.
  10. Sep 12, '08 by
    Quote from yeSICU
    The nurse should have used this as a teaching opportunity, and then you probably wouldn't be asking this question.
    I'm not asking a question. I KNOW where the pulse is. I am just shocked that a nurse would not- but would pretend to.

    I think it is horrifying that someone would disregard such a vital component of this patient's care!
  11. Sep 12, '08 by
    :chuckle

    Im sorry, I couldn't control myself.

    Maybe she was a new grad. Or an old one, Im not sure if they emphasize on teaching pedal/popliteal/femoral pulses.