# The patient's pulse demonstrates ______ deficit, where the number of heart sounds exceeds the number of peripheral pulses felt.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168399  
> language: ko  
> subject: Diseases of the circulatory system

## 문제

The patient's pulse demonstrates ______ deficit, where the number of heart sounds exceeds the number of peripheral pulses felt.

## 보기

1. pulse **✔ 정답**
2. beat
3. rhythm
4. pressure
5. volume

**정답: 1**

## 해설

Pulse deficit occurs when there is a discrepancy between the number of heart sounds heard and peripheral pulses palpated. This finding is common in atrial fibrillation, where some contractions may be too weak to generate a palpable peripheral pulse.

## 임상 시나리오

1. Pulse deficit definition: Difference between apical heart rate and peripheral pulse rate

2. Common causes:
- Atrial fibrillation
- Premature contractions
- Weak ventricular contractions
- Heart blocks

3. Clinical assessment:
- Compare apical pulse with radial pulse
- Count for full minute
- Normal finding: Equal rates
- Deficit: Apical rate > Radial rate

4. Associated conditions:
- Cardiac arrhythmias
- Heart failure
- Valvular heart disease
- Cardiomyopathy

5. Key points:
- Diagnostic value in cardiac assessment
- Indicates ineffective cardiac output
- Requires immediate medical attention
- Important vital sign measurement

6. Documentation:
- Record both apical and radial rates
- Calculate deficit
- Note rhythm irregularities
- Monitor trends

## 핵심 개념

- **pulse** — The rhythmic expansion and contraction of arteries caused by the heart pumping blood through the body
- **beat** — A single complete pulsation of the heart, consisting of one contraction and dilation
- **rhythm** — The pattern or regularity of heartbeats, including their frequency and intervals
- **pressure** — The force exerted by blood against the walls of blood vessels, measured in millimeters of mercury
- **volume** — The amount of blood pumped out by the heart in each contraction or over a specific time period

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