Quote from studentkk
Any tips on how to count an apical rate in infants or small children? I find it difficult to keep count with the more rapid heart rates
First off, you have to be quick in peds...
as opposed to neonatology where the patients are often quiet enough to assess, you may only have brief periods to count a pulse...think about the outpatient or clinic nurse in a well child visit. Children are not always cooperative in assessment, toddlers are tough in the outpatient setting...lol
Do as much of your nursing exam in the mother's arms as possible...in the hospital parents should be bedside other than in critical situations.
Of course, as others have stressed, assessing the apical heart sounds is essential in all settings but not necessarily high priority in some situations.
If the HR is regular count for 15 sec...but be prepared to remember what number you had at 6 and 10 secs...do the math to get your hr...confirm with same process using a peripheral pulse. I prefer the brachial pulse in the outpatient setting because it is easy to perform without requiring that the child's distal extremity be restrained. You can get by with this for rate...commenting on rhythm requires a more thorough assessment requiring more time.
I agree that tapping your finger or similar can help...