A recently admitted client has simultaneous pulse measurements: apical pulse 106/min and radial pulse 93/min. How should the nurse document this finding?

• A. Pulse deficit less than 10
• B. Radial pulse irregular
• C. Apical pulse greater than radial
• D. Pulse deficit of 13/min

Answer: (D)

Pulse deficit is the difference between the heart rate heard at the apex and the peripheral pulse rate. When the apical rate is higher than the radial rate, some heartbeats don’t produce a palpable peripheral pulse. Here, the apical pulse is 106/min and the radial pulse is 93/min, giving a difference of 13/min. Documenting as a pulse deficit of 13/min communicates both the presence and the magnitude of the deficit, which can indicate abnormal cardiac function or rhythm and warrants further rhythm assessment and monitoring. The relationship apical greater than radial is true but doesn’t specify the magnitude; the other phrasing either omits the deficit or misinterprets the data.