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Bounding radial pulse: A bounding pulse indicates increased blood volume or pressure, not impaired tissue perfusion. Conditions like fever, anxiety, or fluid overload can cause bounding pulses.

Irregular apical pulse: An irregular apical pulse suggests a cardiac conduction issue (e.g., atrial fibrillation) but doesn’t directly validate peripheral tissue perfusion.

Carotid pulse stronger on the left side than the right: Asymmetrical carotid pulses can indicate localized vascular disease or structural abnormalities, but this reflects central circulation, not necessarily peripheral tissue perfusion.

A client who is in shock: In shock, peripheral perfusion is often poor, making the radial pulse weak or unpalpable. While that may seem like a reason to check the apical pulse, the priority in shock is rapid stabilization, not detailed pulse analysis.

A client whose pulse changes with body position changes: Pulse variations with postural changes (e.g., orthostatic hypotension) can still be accurately assessed using the radial pulse. The key in this scenario is to observe trends in heart rate and blood pressure during position changes.

A client who had surgery less than 24 hours ago: Postoperative clients are routinely monitored using the radial pulse unless there is a specific cardiovascular concern such as arrhythmia or instability.

Pulse refers to the palpable rhythmic expansion of arteries as blood is ejected from the heart. It reflects heart rate and rhythm, but it is not a volume measurement.

Cardiac Output (CO) is the total volume of blood the heart pumps per minute and is calculated as:CO = Stroke Volume × Heart Rate.

Pulse Pressure is the difference between systolic and diastolic blood pressures (e.g., 120/80 → pulse pressure = 40 mmHg).

Check the pulse again in 2 hours: Delaying action for 2 hours could result in missed early intervention if the client is experiencing a medical emergency such as arrhythmia or sepsis.

Check the blood pressure: Checking blood pressure is a reasonable follow-up when a tachycardic pulse is noted, as it helps assess perfusion and cardiovascular stability. However, this step should be secondary to reporting the abnormal pulse.

Record the information: Documentation is important, but simply recording without reporting an abnormal rate of 140 bpm fails to meet the nurse's responsibility to act on critical findings.