What is it?
A drop in blood pressure that occurs when a person changes to an upright position, especially from lying down to standing.
- Blood temporarily pools in the lower body after standing.
- Normally, the body compensates by increasing vascular tone and adjusting heart rate.
- In orthostatic hypotension, this compensation may be inadequate.
Clinical definition: A sustained decrease in systolic blood pressure of at least 20 mmHg or diastolic blood pressure of at least 10 mmHg within three minutes of standing or head-up tilt.
Why does it matter?
- May reduce blood flow to the brain.
- Can cause dizziness, fainting, and falls.
- May limit safe transfers and ambulation.
Possible contributors: - Dehydration or blood loss.
- Prolonged bed rest.
- Certain medications.
- Autonomic nervous system dysfunction.
What should I look for?
Common symptoms after sitting or standing:
- Dizziness or lightheadedness.
- Weakness or faintness.
- Blurred vision.
- Nausea.
- Sweating or unusual pallor.
- Syncope (fainting).
Important: Some residents may have orthostatic blood pressure changes without noticeable symptoms.
What should I do?
- Follow the care plan for mobility assistance.
- Help the resident change positions gradually.
- Use Dangling at Bedside when indicated.
- Observe tolerance before standing or walking.
- If symptoms occur, help the resident into a safe position.
- Do not continue ambulation while the resident is dizzy or faint.
- Notify the nurse about new or worsening symptoms.
- Measure positional blood pressure only when directed and trained.
Urgent: Loss of consciousness, chest pain, severe breathing difficulty, or other concerning symptoms require immediate escalation.
Related
- Blood Pressure
- Hypotension
- Dehydration
- Blood Loss
- Dangling at Bedside
- Fall Risk
- Assisting with Ambulation
Sources
- CNA Module 5 — Mobility & Transfers
- CNA Module 12 — Emergency Procedures
- AAFP — Orthostatic Hypotension
Flashcards
What is the clinical BP-drop definition of orthostatic hypotension?02-mechanisms / diseases-conditions
Answer
At least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes upright.
What should be done if standing causes dizziness?03-application / diseases-conditions
Answer
Help the resident safely sit or lie down and report symptoms.