Pulse Apika

Anter

• Hōʻike Overview
• Pahuhopu
• Pehea e loaʻa ai ka pulse apical?
• Nā helu pahuhopu
• Deficit pulse
• Lawe aku

Hōʻike Overview

ʻO kou pulse ka haʻalulu o ke koko i ka puʻuwai ʻana o kou puʻuwai iā ia i loko o kāu mau aʻa. Hiki iā ʻoe ke haha ​​i kou pulse ma ke kau ʻana i kou mau manamana lima ma luna o kahi aʻa nui e moe kokoke ana i kou ʻili.

ʻO ka lāʻau pulse apical kekahi o nā wahi pana lāʻau maʻamau maʻamau he ʻewalu. Hiki ke loaʻa ma ke kikowaena hema o kou umauma, ma lalo pono o ka piko. Kūlike kēia kūlana i ka hopena haʻahaʻa (kuhi) o kou puʻuwai. E nānā i kahi kiʻikuhi kikoʻī o ka ʻōnaehana puni.

Pahuhopu

Ke hoʻolohe nei i ka pulse apical ke hoʻolohe pono nei i ka puʻuwai. He ala hilinaʻi loa ia a noninvasive e loiloi i ka hana naʻau. ʻO ia nō ke ala makemake ʻia no ke ana ʻana i ka helu o ka puʻuwai i nā keiki.

Pehea e loaʻa ai ka pulse apical?

Hoʻohana ʻia kahi stethoscope e ana i ka lāʻau lāʻau lāʻau apical. Pono ʻia kahi uaki a lima paha me nā kekona.

Loiloi maikaʻi ʻia ka pulse apical ke noho ʻoe a moe paha i lalo.

E hoʻohana kāu kauka i kahi moʻo o "nā palena ʻāina" i kou kino e ʻike ai i ka mea i kapa ʻia ʻo ke kiko o ka impulse maximal (PMI). ʻO kēia mau palena ʻāina:

• ke kiko iwi o kou sternum (umauma)
• nā wahi intercostal (nā hakahaka ma waena o kou iwi iwi ʻaoʻao)
• ka laina waena (kahi laina kuhi e neʻe ana i lalo i kou kino e hoʻomaka ana mai ka waena o kāu iwi)

Ke hoʻomaka nei mai ka lae o kou umauma, e ʻike kāu kauka i ka lua o ka hakahaka ma waena o kou mau iwi ʻaoʻao. E hoʻoneʻe lākou i ko lākou mau manamana lima i lalo i ka wahi ʻelima ma waena o kou mau iwi ʻaoʻao a paheʻe iā lākou i ka laina waena. E loaʻa ka PMI ma aneʻi.

Ke loaʻa ka PMI, e hoʻohana kāu kauka i ka stethoscope e hoʻolohe i kāu pulse no hoʻokahi minuke i mea e loaʻa ai kāu helu pulse apical. Kela a me kēia "lub-dub" kani kāu puʻuwai e helu ai ma ke ʻano he beat hoʻokahi.

Nā helu pahuhopu

Kuhi ʻia kahi helu pulse apical i mea maʻamau ʻole i ke kanaka makua inā ma luna o 100 mau kuʻi i kēlā me kēia minuke (bpm) a i ʻole ma lalo o 60 bpm. ʻO kāu helu puʻuwai kūpono i ka hoʻomaha a me ka wā o ka hoʻoikaika kino ʻana he ʻokoʻa loa.

Loaʻa i nā keiki ke kiʻekiʻe o ka pulse hoʻomaha hoʻomaha ma mua o nā mākua. ʻO nā pae pulse hoʻomaha maʻamau no nā keiki penei:

• hānau hou: 100-170 bpm
• 6 mahina i 1 makahiki: 90-130 bpm
• 2 a 3 mau makahiki: 80-120 bpm
• 4 a 5 mau makahiki: 70-110 bpm
• 10 mau makahiki a ʻoi paha: 60-100 bpm

Ke kiʻekiʻe ka lāʻau pulse apical ma mua o ka mea i manaʻo ʻia, e loiloi kāu kauka iā ʻoe no kēia mau mea:

• makaʻu a hopohopo paha
• fiva
• hana hoʻoikaika kino hou
• ʻeha
• hypotension (haʻahaʻa ke koko,)
• lilo ke koko
• lawa ʻole ka lawe ʻana o ka oxygen

Hoʻohui ʻia, ʻo ka helu o ka puʻuwai i ʻoi aku ka kiʻekiʻe ma mua o ka maʻamau hiki ke lilo i hōʻailona o ka maʻi puʻuwai, ka puʻuwai puʻuwai, a i ʻole kahi thyroid gland overactive.

Ke haʻahaʻa ka lāʻau pulse apical ma mua o ka mea i manaʻo ʻia, e nānā kāu kauka no ka lāʻau i hiki ke hoʻopili ʻia i ka helu o kou puʻuwai. ʻO ia mau lāʻau e pili ana i nā beta-blockers i hāʻawi ʻia no ke koko kiʻekiʻe a i ʻole nā ​​lāʻau anti-dysrhythmic i hāʻawi ʻia no ka puʻuwai puʻuwai ʻole.

Deficit pulse

Inā ʻike kāu kauka he kūlike ʻole kāu pulse apical, e nānā paha lākou no ka loaʻa ʻana o kahi deficit pulse. Koi paha kāu kauka iā ʻoe he electrocardiogram.

Pono ʻelua mau kānaka e loiloi i ka deficit pulse. Ana kekahi i ka pulse apical ʻoiai ana ka mea ʻē aʻe i kahi pulse peripheral, e like me ka mea i kou lima. E helu ʻia kēia mau puʻupuʻu i ka manawa like no hoʻokahi minuke piha, me kahi mea e hāʻawi ana i ka hōʻailona i kekahi e hoʻomaka i ka helu ʻana.

I ka manawa i loaʻa ai nā uku pālena, ua unuhi ʻia ka helu pulse peripheral mai ka helu pulse apical. ʻAʻole e emi ka helu pulse apical ma mua o ke ana o ka pulse peripheral. ʻO ka hopena ka hopena o ka pulse deficit. ʻO ka maʻamau, like nā helu ʻelua, a laila loaʻa ka ʻokoʻa o ka ʻole. Eia nō naʻe, ke loaʻa he ʻokoʻa, kapa ʻia ia deficit pulse.

Ke hōʻike nei ka loaʻa ʻana o ka deficit pulse e loaʻa paha kahi pilikia me ka hana o ka puʻuwai a i ʻole ka maikaʻi. Ke ʻike ʻia kahi deficit pulse, ʻo ia hoʻi ʻaʻole i lawa ka nui o ke koko i kaʻi ʻia mai ka puʻuwai e kūpono i nā pono o nā kino o kou kino.

Lawe aku

Ke hoʻolohe nei i ka pulse apical ke hoʻolohe pono nei i kou puʻuwai. ʻO ia ke ala kūpono loa e loiloi i ka hana puʻuwai.

Inā aia kāu pulse ma waho o ka pae maʻamau a i ʻole he kuʻi puʻuwai ʻole kāu, e loiloi hou kāu kauka iā ʻoe.