Apical-radial or A-R pulse is an assessment of apical and radial pulses simultaneously.

The readings for each must remain the same. A variation is known as a pulse deficit.

Pre-procedural preparation includes preparing the equipment, which consists of a watch, a stethoscope, antiseptic wipes, and a vital signs flow sheet.

Next, identify and approach the patient. Explain the procedure, obtain verbal consent, perform hand hygiene, and maintain privacy.

During the procedure, clean the diaphragm and earpieces of the stethoscope with an alcohol swab. Instruct the patient to sit on the bed or lie in a supine position.

There are two methods to assess the A-R pulse.

First is the two-nurse method, where one nurse listens to the apical pulse with a stethoscope over the apex while the other counts the radial pulse.

Another is the one-nurse method, where the nurse assesses the apical pulse first, followed by the radial pulse.

Finally, post-procedure steps include making the patient comfortable, replacing the equipment, performing hand hygiene, and documenting the findings.