When administering the first dose of antihypertensive medication to an older adult, the nurse should recognize the related risk to possible side effects such as orthostatic hypotension. Orthostatic hypotension is a common side effect of antihypertensive medications, especially in older adults. It is a sudden drop in blood pressure that occurs when a person stands up from a sitting or lying position, leading to symptoms such as dizziness, lightheadedness, and even fainting.
Older adults are more susceptible to orthostatic hypotension due to age-related changes in the cardiovascular system, such as decreased baroreceptor sensitivity and decreased vascular compliance. Other risk factors for orthostatic hypotension include dehydration, bed rest, and certain medications.
To minimize the risk of orthostatic hypotension in older adults who are starting antihypertensive medication, the nurse should:
- Monitor blood pressure and heart rate before and after administration of the medication
- Start with a low dose and gradually increase as tolerated
- Encourage the client to change positions slowly, especially when getting up from a lying or sitting position
- Ensure adequate hydration and nutrition
- Monitor for signs and symptoms of orthostatic hypotension, such as dizziness and lightheadedness, and report them to the healthcare provider.
By recognizing the potential risk of orthostatic hypotension and taking appropriate measures to minimize it, the nurse can help ensure the safe and effective use of antihypertensive medication in older adult clients.