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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #188

Woman, fitness and heart rate neck pulse, wellness and training challenge in urban city outdoor. Yo

I want to cover heart rate. While this is Physiology 101, I still think it makes for a great reminder! 

There are both intrinsic and extrinsic factors that can influence heart rate. Intrinsic factors include the patient’s age, gender, and genetic makeup, while extrinsic factors include environmental factors such as stress, anxiety, physical activity, and medications.

When it comes to intrinsic factors, there is little you can do about that. But extrinsic factors are typically something the nurse practitioner can assess and address.

Certain medications, such as beta-blockers and calcium channel blockers, can lower heart rate by decreasing the activity of the sympathetic nervous system, which regulates heart rate. Other medications, such as stimulants and decongestants, can increase heart rate by stimulating the sympathetic nervous system. These are things you generally know.

In addition to medications, other extrinsic factors such as fever, dehydration, and electrolyte imbalances can also affect heart rate. In some cases, underlying medical conditions such as hyperthyroidism, anemia, and cardiac arrhythmias can also cause changes in heart rate. So, always be cognizant of those factors in patients who present with a high resting heart rate!

When assessing a patient’s heart rate, it is important to consider these various factors and obtain a baseline heart rate measurement in a calm and resting state. Monitoring changes in heart rate over time and in response to interventions can also provide valuable information about a patient’s cardiovascular status. Overall, you should understand these factors as it will help you adequately assess and treat your patient by simply looking at the heart rate from a more critical perspective.

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