am I the worlds worst nurse?

[brownbook]

Yikes, I responded to a student post about checking poptiteal pulses and another responder mentioned every nurse should be checking their patient's radial and pedal pulses on every assessment! I've been in many areas of acute care and out patient nursing. The past 10 years my patients have been connected to pulse oximeters and auto bp cuffs. Even 15-20 years ago when my patients weren't connected to any monitors I would never think I should check radial and pedal pulses on every patient! Sure I can think of many reasons I would check various pulses. But geez, a kind of baseline healthy patient admitted with asthma, I'm going to check their pedal pulses???? What am I missing here?

[emtoh17]

Usually vascular or cardiac disease and as previously mentioned, diabetics.

[mammac5]

Looking at and touching a patient's feet and LE tells the nurse a lot of information.

Skin: Is it intact? Is the color what it should be? Is hair growing in a normal pattern and equally on both feet/LE? Is the skin normally dry OR is is overly-dry or moist? Any evidence of infection of the nails? Has the patient been able to follow good hygiene prior to hospitalization? Is there odor?

Temp: Does the skin feel too warm or too cold compared to the rest of the body?

MS: Does the pt have full ROM in the feet/toes/etc. Normal strength?

CVS/PVS: Is perfusion normal? Pulses of normal strength bilaterally? Capillary refill of 3 sec or less? Deficits or inequalities can be an early sign of perfusion problems. Edema or signs of inadequate fluid volume? Caught early, some complications might be avoided such as skin breakdown, infection, peripheral neuropathy, sensory losses that could lead to injuries/falls...

Anytime there is diminished tissue perfusion, we have to think about the kidneys.

[Penelope_Pitstop, BSN, RN]

If you are not checking the radial and popliteal pulses, then how do you know what your baseline is?? And how in the world would you know what is normal or abnormal for your pt if you never checked in the first place???

Unless a patient has a known DVT, just had surgery, or have BKAs...I don't check the popliteal. It's not part of my routine assessment. Distal pulses, to me, are more important.

I do check pedal pulses. I do it while assessing for edema. I'm down there anyway, might as well check a pulse and extremity strength. Hey, I just did a few assessments in one!

As for radial, I assess for those while I'm listening to the apical rate.

To answer the OP's question, dear heavens, you are not even CLOSE to being the world's worst nurse. Trust me, I know her. :)