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Andrew Pollack-Gray

Nursing Notes

Hypotension

2 min read

What is it?

Hypotension is blood pressure that is abnormally low for the person’s needs or circumstances.

  • Often described as systolic blood pressure below 90 mmHg or diastolic pressure below 60 mmHg.
  • These values are general reference points, not universal treatment or reporting thresholds.
  • Some healthy people naturally have relatively low blood pressure without symptoms.

How does it work?

Blood pressure can fall because of:

Reduced Cardiac Output

  • Reduced circulating blood volume.
  • Decreased ventricular filling.
  • Heart dysfunction.

Reduced Systemic Vascular Resistance

  • Excessive vasodilation.
  • Certain medications.
  • Some types of shock.

Reduced Circulating Volume

Why does it matter clinically?

Low blood pressure can reduce blood flow to vital organs.
Possible effects include:

  • Dizziness or lightheadedness.
  • Weakness.
  • Fainting.
  • Falls.
  • Reduced tissue perfusion.
  • Shock when circulation becomes critically inadequate.

What should I look for?

Possible Symptoms:

  • Dizziness or faintness.
  • Blurred vision.
  • Unusual fatigue or weakness.
  • Nausea.
  • Confusion.
  • Syncope (fainting).
    Other Observations:
  • Lower-than-usual blood pressure.
  • Rapid or weak pulse.
  • Cool or clammy skin.
  • Changes in alertness.
  • Symptoms associated with sitting or standing.

Orthostatic Hypotension

A blood pressure decrease associated with moving upright.
Commonly defined as:

  • Systolic decrease of at least 20 mmHg, or
  • Diastolic decrease of at least 10 mmHg,
    within three minutes of standing or head-up tilt.
    See Orthostatic Hypotension for details.

What should I do?

  • Observe symptoms and changes from baseline.
  • Measure blood pressure according to training and facility policy.
  • Notify the nurse of symptomatic or unexpected low readings.
  • Assist residents with changing positions safely.
  • Stop ambulation or transfers if the resident becomes dizzy or faint.
  • Help the resident into a safe position and summon assistance.
  • Activate emergency response for unresponsiveness, severe symptoms, or suspected shock.
    CNA Scope: CNAs identify concerning observations and report them. Causes, diagnosis, and treatment are determined by qualified clinicians.

Sources

Flashcards

What does hypotension describe?01-foundations / diseases-conditions
Answer

Blood pressure abnormally low for the person's circumstances.

Why might hypotension cause fainting?02-mechanisms / diseases-conditions
Answer

Insufficient blood flow to the brain.

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