The electronic pulse oximeter is in use and, although you would rather not do it, you take the patient’s pulse manually. while counting the pulse you notice it seems irregular and every so often it seems to feel stronger. you look at the patient who appears pale and has a slight grimace on his face.

If a healthcare provider notices any type of abnormality related to the pulse, then it is imperative that he or she does brief but straight to the point assessment.  The healthcare provider can ask the patient in a calm manner, "What are you feeling right now?"  And because a grimace has been noted, another appropriate question would be, "Are you in pain?"  If the patient is in pain, the next question to ask would be, "On a scale of 1-10 with 10 being the highest, how would you rate your pain?"  The healthcare provider can also check the blood pressure of the patient in order to verify the presence of hemorrhage.