1. Provide a brief explanation of what orthostatic hypotension is and identify the vital signs and their values that define orthostatic (postural) hypotension.
Orthostatic hypotension is when a person’s blood pressure decreases whenever they go from a lying position to sitting up or standing. This is due to blood leaving the core of the body (organs) and shunts to the peripheries due to vasodilation. This usually makes the patient feel dizzy or light-headed and can cause a patient to become unsteady and/or fall. If a patient has orthostatic hypotension, their pulse will increase 15-30 bpm or blood pressure will decrease by 20 mmHg systolic or 10 mmHg diastolic (Nursing: A concept-based, 2015, pp. 1067-1068).
2. Explain the steps of assessing…show more content… This assessment asks questions that would be indicative of an increased risk for a fall such as the patient’s age, level of consciousness, any medications the patient may be on that is potentially sedating or cause problems with gait, and if they have a prior history that includes a fall. This tool is used on every patient so that the hospital can decrease the risk of injuries. The precautions that can/will be implemented on a patient with a high risk for a fall includes a bed and/or chair alarm, so if the patient is noncompliant with calling the nurse before getting up, the alarm will sound, alerting staff, making sure anything the patient needs, including the call light, is well within reach, responding to a call as soon as possible, keeping side rails up (one must always stay down), and make sure the bed is always at the lowest position unless actively working with the patient. Other precautions include putting a fall risk armband on the patient as a reminder, putting the patient in a room near the nurses station, making sure there is adequate lighting, especially at night, encouraging patient to wear slippers or non-skid socks when out of bed, and if a patient has a cognitive impairment that hinders their ability to follow instructions, a sitter can be ordered to stay in the room with…show more content… O’Brien’s pulse and blood pressure and we already know that he is breathing because he is talking to the nurse. Next, she should check Mr. O’Brien for cuts, bruises, or broken bones and assess his pain level on a pain scale from 1-10. Since the nurse was not in the room when the fall occurred, she should ask him what happened and make sure to document it later when the situation is over, and Mr. O’Brien is stable. The nurse should call for help and stay with the patient until help arrives, making sure not to move the patient until it can be determined that the patient is not hurt, and the nurse has help with getting the patient back up into a wheelchair or the bed (Nursing: A concept-based,