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Susan is an RN on a busy Med-Surg floor. She is caring for 7 patients, and there are 2 UAP’s assigned to the 22-bed unit. Susan assessed for orthostatic hypotension in an elderly client. The blood pressure reading in a supine position is 152/80, and the blood pressure reading in a standing position is 106/68. The client complains of slight dizziness upon standing.

What are the priority concerns for this client, with regard to these blood pressure readings?

User Lomboboo
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Final answer:

The client's priority concerns include the risk of falls due to dizziness from orthostatic hypotension. The nurse should ensure safety through fall precautions and potentially adjust medications or hydration as needed. Monitoring the client's blood volume and cardiovascular response to postural changes is crucial to management.

Step-by-step explanation:

The priority concerns for a client with a blood pressure reading of 152/80 mm Hg in a supine position and 106/68 mm Hg in a standing position, along with complaints of slight dizziness upon standing, are symptoms of orthostatic hypotension. Orthostatic hypotension occurs when the cardiovascular system fails to compensate quickly enough for postural changes, resulting in a temporary reduction of blood flow to the brain. This can cause dizziness, lightheadedness, and in extreme cases, fainting or falls. Susan, as an RN, should prioritize measures to ensure the client's safety, such as assisting with ambulation and implementing fall precautions. Additionally, investigating the cause of the orthostatic hypotension is important, looking into potential factors like dehydration, medication effects, or systemic health issues.

Given that orthostatic hypotension can be exacerbated by factors such as dehydration or the use of certain medications (like diuretics or vasodilators), Susan's management plan may include hydration strategies or reviewing and adjusting medications as needed, in consultation with the healthcare team. She may also monitor the patient's blood volume levels and cardiovascular response to postural changes to personalize care and minimize the risk of complications associated with hypotension.

User Johan Petersson
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