Nursing care plan for orthostatic hypotension

Nursing care plan for orthostatic hypotension

Introduction

Nursing Care Plan for Orthostatic Hypotension is a plan of evaluation and intervention plan for patients who suffer from low blood pressure when standing. Orthostatic hypotension is a medical condition that causes a person’s blood pressure to drop quickly upon standing up, leading to dizziness or lightheadedness. It is most commonly seen in older patients, but can occur to people of all ages.

Assessment

History: The nursing care plan begins with a complete assessment of the patient. This includes taking a detailed history of the patient’s symptoms. Questions concerning the frequency and duration of episodes, contributing factors and other health issues are important in order to properly diagnose and manage the orthostatic hypotension.

Physical Examination: A physical examination may include measuring the patient’s heart rate and blood pressure, checking for any signs of dehydration, examining the legs for edema, and inspecting skin for jaundice and pallor. Additionally, a neurologic assessment will be conducted to assess functionality.

Laboratory Tests: Laboratory tests which may be ordered include a complete blood count (CBC), renal panel, electrolyte test, thyroid function, hemoglobin A1C, and urinalysis.

Nursing Diagnosis

Hypovolemia: Hypovolemia, or decreased volume of blood in circulation, often occurs in patients suffering from orthostatic hypotension. Symptoms of this diagnosis include dizziness, thirst, fatigue, pale skin, and shortness of breath.

Impaired Physical Mobility: Patients with Orthostatic Hypotension may experience impaired physical mobility due to their unsteadiness and dizziness.

Outcomes

Patient Will: The patient will demonstrate increased safety by reporting a decrease in dizziness, diaphoresis, and syncope within 24 hours of initiating the nursing care plan.

Patient Will: The patient will verbalize an understanding of their condition, medications, and lifestyle changes necessary for proper management.

Interventions

Positional Changes: Keeping the patient in an upright position for prolonged periods of time and limiting sudden changes from a prone to an upright position should be avoided. To reduce dizziness, it is best to change positions slowly and provide assistance, if needed.

Fluid Management: Fluids and electrolytes should be monitored and adjusted as needed. Additionally, salt tablets and cool compresses may be recommended to improve symptoms.

Medication: Medications that may be used include fludrocortisone, droxidopa, and midodrine. These medications help to increase the amount of sympathetic activity and increase the amount of blood being circulated.

Rationales

Positional Changes: Changes in the patient’s position can help to improve their symptoms, as well as promote safety by preventing falls.

Fluid Management: Proper fluid and electrolyte management will help to maintain adequate circulation and normal blood pressure.

Medication: Medications can help to regulate blood pressure and reduce symptoms.

Evaluation

The patient’s progress should be evaluated based on the achievement of outcomes, reduction in symptoms, adherence to the nursing care plan, and understanding of the condition.

Conclusion

Nursing Care Plans for Orthostatic Hypotension can provide the patient with the necessary interventions and support to safely manage their condition. With planned interventions and appropriate monitoring, the patient should be able to regain a sense of comfort and foster a sense of independence.

FAQs

  • What is Orthostatic Hypotension? Orthostatic hypotension is a medical condition that causes a person’s blood pressure to drop quickly upon standing up, leading to dizziness or lightheadedness.
  • What are the symptoms of Orthostatic Hypotension? Symptoms can include dizziness, thirst, fatigue, blurred vision, palpitations, and confusion.
  • What treatments are available? Treatments include positional changes, fluid management, and medications.
  • Who is most at risk for Orthostatic Hypotension? It is most commonly seen in older patients, but can occur to people of all ages.
  • Are there any lifestyle changes I can make? Yes, avoiding alcohol, caffeine, and smoking and increasing fluid intake can help reduce the risk of Orthostatic Hypotension.

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