d. Medications. Stimulants will increase the pulse rate; depressants will decrease
the pulse rate.
e. Exercise and Muscular Activity. An increase in pulse rate will occur with
increased activity to meet increased oxygen and nutrient demands. A regular aerobic
exercise program can lower the resting pulse. A person, who exercises a great deal, such
as an athlete, will develop bradycardia that is a normal, health condition. The body slows
the heartbeat to compensate for the greater volume of blood pumped with each beat.
f. Food Intake. Digestion increases the pulse slightly.
g. Elevated Body Temperature. The pulse increases approximately 10 beats per
minute for every 1 F (0.56 C) increase in body temperature. These conditions cause a
temporary increase in the heartbeat and pulse.
h. Emotional Status. Fear, anger, and anxiety will all increase the pulse rate.
Pain. When the patient is in pain, the pulse rate will increase.
4-15. MEASURING THE PULSE
a. Measuring a Radial Pulse.
Wash your hands to prevent the spread of infection.
(2) Supporting the patient's arm and hand with the palm down, press the first,
second, and third finger of your dominant hand gently against the radius bone until you
feel the contraction and expansion of the artery with each heartbeat. Do not use your
thumb; it has a strong pulse of its own and you may be counting your pulse.
(3) Count the pulsations for 30 seconds using a watch with a second hand or
digital display to time yourself. Multiply the count by 2 to determine the rate for 1 minute.
If the pulse is abnormal in any way, count for a full minute to get a more accurate reading.
(4) The pulse rate may also be determined by the electronic vital signs
monitor (see figure 4-3).
If there is any doubt about the rhythm or rate of the heart, take an apical