Orthostatic Hypotension Case Study

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Questions:

Provide a brief explanation of what orthostatic hypotension is, and identify the vital signs and their values that define orthostatic (postural) hypotension.
Orthostatic hypotension occurs when an individual moves from a supine to a sitting or standing position. In an episode of OH, blood is pulled to the lower extremities by gravity. This pooling of blood stimulates the baroreceptors, sending a message to the vasomotor center of the brain and causing sympathetic nervous system activation. This results in an increased heart rate, which in turn increases the blood pressure and improves circulation back to the upper body . When this mechanism fails to work and perfusion is not rapidly returned to the brain,
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Individual risk factors include age, history of falls, impaired mobility or unsteady gait, issues of urinary elimination, use of certain medications, weakness, delirium, orthostatic hypotension, comorbid conditions, impaired vision, mental status changes, and acute illness. Environmental risk factors include inadequate lighting, uneven floor surfaces, objects on the floor that present a trip hazard, heights of chairs, lack of support bars in bathrooms, poor footwear, insufficient assistive devices, and inadequate availability of health care staff. (Rheaume, J.,…show more content…
Physical restraint, which is used most commonly, involves use of an intervention or device that hinders the patient from moving or restricts the individual from contact with his or her body. According to Springer, physical restraint generally involves one or more of the following: • A wrist, ankle, or abdomen restraint • A sheet tucked in so tight it restricts movement • The use of all side rails to prevent the patient from leaving the bed • The use of an enclosure bed • Tightly holding the patient so he or she cannot move limbs or head and cause further damage to self or others. chemical restraints may be used after physical restraints are removed. Although injections or oral medications (e.g., tranquilizers such as haloperidol may be used as restraints, they may not be documented as such. For example, a healthcare provider may order haloperidol for someone who experiences aggression and insomnia after a surgical treatment. If this medication was not considered a standard treatment for the patient’s condition, it could be viewed as a chemical restraint. Nurses should follow institutional policy and accrediting agencies standards. Employees should have easy access to forms or electronic documentation to verify provision of safe care to the patient in restraints. Healthcare providers should ensure the restraint is used for the least amount of time; patients should have circulation checks of a

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