Treatments for Orthostatic hypotension
Treatments for Orthostatic hypotension
The list of treatments mentioned in various sources
for Orthostatic hypotension
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
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Discussion of treatments for Orthostatic hypotension:
When orthostatic hypotension is caused by hypovolemia
due to medications, the disorder may be reversed by adjusting the dosage
or by discontinuing the medication. When the condition is caused by
prolonged bed rest, improvement may occur by sitting up with increasing
frequency each day. In some cases, physical counterpressure such as
elastic hose or whole-body inflatable suits may be required. Dehydration
is treated with salt and fluids.
(Source: excerpt from
NINDS Orthostatic Hypotension Information Page: NINDS)
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Book Excerpts: Treatment of Orthostatic hypotension
- Treatment - Hypotension
- Emergency interventions - Blood pressure decrease [Hypotension]
- Emergency interventions - Pulse pressure, widened
- Emergency interventions - Pulsus paradoxus
- Emergency interventions - Orthostatic hypotension [Postural hypotension]
- Emergency interventions - Blood pressure decrease [Hypotension]
- Emergency Interventions - Pulse pressure, widened
- Emergency Interventions - Pulsus paradoxus
- Emergency Interventions - Orthostatic hypotension [Postural hypotension]
- Emergency interventions - Decorticate posture [Decorticate rigidity, abnormal flexor response]
- Nursing considerations - Pulse pressure, widened
- Nursing considerations - Hypotension, orthostatic
- Nursing considerations - Pulsus paradoxus [Paradoxical pulse]
- Nursing considerations - Decorticate posture [Decorticate rigidity, abnormal flexor response]
- Emergency Actions - Pulse pressure, widened
- Emergency Actions - Pulsus paradoxus
- Emergency Actions - Orthostatic hypotension
- Emergency Actions - Decorticate posture
- Nursing considerations - Pulse pressure, widened
- Nursing considerations - Pulsus paradoxus
- Nursing considerations - Orthostatic hypotension [Postural hypotension]
- Nursing considerations - Blood pressure, decreased [Hypotension]
- Nursing considerations - Decorticate posture [Decorticate rigidity, abnormal flexor response]
Treatments of Orthostatic hypotension: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the treatments of Orthostatic hypotension.
Hypotension:
Treatment
(In a Page: Signs and Symptoms)
-
Orthostatic hypotension: Increase salt and water intake; pharmacologic treatment for moderate to severe disease may include fludrocortisone acetate, sympathomimetic agents, NSAIDs, caffeine, and erythropoietin
-
Volume depletion: Fluid replacement based on existing deficiencies (e.g., saline, dextrose, potassium, packed red blood cells)
-
Remove offending medications, compensate for medication needs
-
Adrenal insufficiency requires stress doses of IV hydrocortisone (100 mg IV every 6 hours)
-
Patient education (e.g., rise slowly from sitting to standing)
>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Blood pressure decrease [Hypotension]:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient's systolic pressure is less than 80 mm Hg, or 30 mm Hg below his baseline, suspect shock. Quickly evaluate the patient for a decreased LOC. Check his apical pulse for tachycardia and his respirations for tachypnea. Also, inspect the patient for cool, clammy skin. Elevate the patient's legs above the level of his heart, or place him in Trendelenburg's position if the bed can be adjusted. Then start an I.V. line using a large-bore needle to replace fluids and blood or to administer drugs. Prepare to administer oxygen with mechanical ventilation, if necessary. Monitor the patient's intake and output and insert an indwelling urinary catheter to accurately measure urine output. The patient may also need a central venous line or a pulmonary artery catheter to facilitate monitoring his fluid status. Prepare for cardiac monitoring to evaluate cardiac rhythm. Be ready to insert a nasogastric tube to prevent aspiration in the comatose patient. Throughout emergency interventions, keep the patient's spinal column immobile until spinal cord trauma is ruled out.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Pulse pressure, widened:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient’s level of consciousness (LOC) is decreased, and you suspect that his widened pulse pressure results from increased ICP, check his vital signs. Maintain a patent airway, and prepare to hyperventilate the patient with a handheld resuscitation bag to help reduce partial pressure of carbon dioxide levels and, thus, ICP. Perform a thorough neurologic examination to serve as a baseline for assessing subsequent changes. Use the Glasgow Coma Scale to evaluate the patient’s LOC. (See Glasgow Coma Scale, page 374.) Also, check cranial nerve function — especially in cranial nerves III, IV, and VI — and assess pupillary reactions, reflexes, and muscle tone. Insertion of an ICP monitor may be necessary. If you don’t suspect increased ICP, ask about associated symptoms, such as chest pain, shortness of breath, weakness, fatigue, or syncope. Check for edema, and auscultate for murmurs.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Pulsus paradoxus:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
Pulsus paradoxus may signal cardiac tamponade — a life-threatening complication of pericardial effusion that occurs when sufficient blood or fluid accumulates to compress the heart. When you detect pulsus paradoxus, quickly take the patient’s other vital signs. Check for additional signs and symptoms of cardiac tamponade, such as dyspnea, tachypnea, diaphoresis, jugular vein distention, tachycardia, narrowed pulse pressure, and hypotension. Emergency pericardiocentesis to aspirate blood or fluid from the pericardial sac may be necessary. Then evaluate the effectiveness of pericardiocentesis by measuring the degree of pulsus paradoxus; it should decrease after aspiration.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Orthostatic hypotension [Postural hypotension]:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If you detect orthostatic hypotension, quickly check for tachycardia, an altered level of consciousness (LOC), and pale, clammy skin. If these signs are present, suspect hypovolemic shock. Insert a large-bore I.V. line for fluid or blood replacement. Take the patient’s vital signs every 15 minutes, and monitor his intake and output. Encourage bed rest.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Blood pressure decrease [Hypotension]:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient’s systolic pressure is less than 80 mm Hg, or 30 mm Hg below his baseline, suspect shock immediately. Quickly evaluate the patient for a decreased LOC. Check his apical pulse for tachycardia and respirations for tachypnea. Also, inspect the patient for cool, clammy skin. Elevate his legs above the level of his heart, or place him in Trendelenburg’s position if the bed can be adjusted. Then start an I.V. line using a large-bore needle to replace fluids and blood or to administer drugs. Prepare to administer oxygen with mechanical ventilation if necessary. Monitor the patient’s intake and output, and insert an indwelling urinary catheter for the accurate measurement of urine. The patient may also need a central venous line or a pulmonary artery catheter to facilitate monitoring of fluid status. Prepare for cardiac monitoring to evaluate cardiac rhythm. Be ready to insert a nasogastric tube to prevent aspiration in the comatose patient. Throughout emergency interventions, keep the patient’s spinal column immobile until spinal cord trauma is ruled out.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Pulse pressure, widened:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Ifthe patient’s level of consciousness (LOC) is decreased, and you suspect that his widened pulse pressure results from increased ICP, check his vital signs and oxygen saturation. Maintain a patent airway. Provide supplemental oxygen and ventilatory support to keep the patient’s partial pressure of arterial oxygen above 90 mm Hg or his oxygen saturation above 95%. Give osmotic diuretics, such as mannitol, by I.V. infusion to decrease ICP. Insert an indwelling urinary catheter; monitor intake and output during mannitol therapy. Start ICP monitoring. Administer analgesics as ordered. Hyperventilation therapy to decrease the patient’s partial pressure of arterial carbon dioxide and to treat ICP remains controversial but may be needed for short intervals when ICP and neurologic deterioration increase. Perform a neurologic examination. Use the Glasgow Coma Scale (see page 480) to evaluate LOC. Check cranial nerve function—especially cranial nerves III, IV, and VI—and assess papillary reactions, reflexes, and muscle tone. Continue ICP monitoring. If you don’t suspect increased ICP, ask about associated symptoms, such as chest pain, shortness of breath, weakness, fatigue, or syncope. Check for edema and auscultate for murmurs.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Pulsus paradoxus:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
A pulsus paradoxus may signal cardiac tamponade—a life-threatening complication of pericardial effusion that occurs when sufficient blood or fluid accumulates to compress the heart. When you detect pulsus paradoxus, quickly check the patient’s other vital signs. Check for additional signs and symptoms of cardiac tamponade, such as dyspnea, tachypnea, diaphoresis, jugular vein distention, tachycardia, narrowed pulse pressure, and hypotension. Emergency pericardiocentesis to aspirate blood or fluid from the pericardial sac may be necessary. Then evaluate the effectiveness of pericardiocentesis by measuring the degree of pulsus paradoxus; it should decrease after aspiration.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Orthostatic hypotension [Postural hypotension]:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If you detect orthostatic hypotension, quickly check for tachycardia, altered level of consciousness (LOC), and pale, clammy skin. If these signs are present, suspect hypovolemic shock. Insert a large-bore I.V. for fluid or blood replacement. Take the patient’s vital signs every 15 minutes, and monitor his intake and output.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Decorticate posture [Decorticate rigidity, abnormal flexor response]:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Obtain vital signs and evaluate the patient’s level of consciousness (LOC). If his consciousness is impaired, insert an oropharyngeal airway, and take measures to prevent aspiration (unless spinal cord injury is suspected). Evaluate the patient’s respiratory rate, rhythm, and depth. Prepare to assist respirations with a handheld resuscitation bag or with intubation and mechanical ventilation if necessary. Also, institute seizure precautions.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Pulse pressure, widened:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
If the patient displays increased ICP, continually reevaluate his neurologic status and compare your findings carefully with those of previous evaluations. Stay alert for restlessness, confusion, unresponsiveness, or a decreased LOC. Keep in mind, however, that increasing ICP is commonly signaled by subtle changes in the patient’scondition, rather than the abrupt development of any one sign or symptom.
Patient teaching
Explain needed dietary modifications such as restricted sodium and saturated fats. Stress the importance of planning rest periods. If the patient has a decreased LOC, discuss specific safety measures. If the condition is related to increased body temperature, discuss fever management, proper cooling measures if exposed to excessive heat for long periods, and proper fluid consumption with the patient.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Hypotension, orthostatic:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Monitor the patient’s fluid balance by carefully recording his intake and output and weighing him daily. To help minimize orthostatic hypotension, advise the patient to change his position gradually. Elevate the head of the patient’s bed, and help him to a sitting position with his feet dangling over the side of the bed. If he can tolerate this position, have him sit in a chair for brief periods. Immediately return him to bed if he becomes dizzy or pale, or displays other signs of hypotension.
Always keep the patient’s safety in mind. Never leave him unattended while he’s sitting or walking; evaluate his need for assistive devices, such as a cane or walker.
Prepare the patient for diagnostic tests, such as hematocrit, serum electrolyte and drug levels, urinalysis, 12-lead electrocardiogram, and chest X-ray.
Patient teaching
The patient with diabetes or another condition that can lead to autonomic dysfunction should be made aware of the acute drop in blood pressure that can occur with positional changes. Inform the patient that, should the problem occur, he’ll need to avoid volume depletion and perform positional changes gradually instead of suddenly. (See Performing preambulation exercises, page 181.)
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Pulsus paradoxus [Paradoxical pulse]:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Prepare the patient for an echocardiogram to visualize cardiac motion and help determine the causative disorder. If a pulmonary embolus is suspected, prepare the patient for a ventilation/perfusion scan. A helical CT scan of the chest or pulmonary arteriogram may also be indicated. Also, monitor his vital signs and frequently check the degree of paradox. An increase in the degree of paradox may indicate recurring or worsening cardiac tamponade or impending respiratory arrest in severe COPD. Vigorous respiratory treatment, such as chest physiotherapy, may avert the need for endotracheal intubation.
Patient teaching
Provide information about the disorder and symptoms to immediately report to the physician. Teach the patient techniques to conserve energy and decrease oxygen demands on the body. Provide information on diagnostic tests and treatment for pulsus paradoxus, including probable oxygen therapy.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Decorticate posture [Decorticate rigidity, abnormal flexor response]:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Monitor neurologic status and vital signs every 30 minutes to 2 hours. Be alert for signs of increased ICP, including bradycardia, increasing systolic blood pressure, and widening pulse pressure.
Patient teaching
Instruct the patient and his family about the signs and symptoms of decreased LOC and seizures. Explain to the family or caregiver how to keep the patient safe, especially during a seizure. Discuss quality of life concerns, if appropriate. Provide referrals to other health care services and professionals, as indicated.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Pulse pressure, widened:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Ifthe patient’s level of consciousness (LOC) is decreased, and you suspect that his widened pulse pressure results from increased ICP, check his vital signs. Maintain a patent airway, and prepare to hyperventilate the patient with a handheld resuscitation bag to help reduce partial pressure of carbon dioxide levels and, thus, ICP. Perform a thorough neurologic examination to serve as a baseline for assessing subsequent changes. Use the Glasgow Coma Scale to evaluate the patient’s LOC. (See Glasgow Coma Scale, page 396.) Also, check cranial nerve function — especially in cranial nerves III, IV, and VI — and assess pupillary reactions, reflexes, and muscle tone. Insertion of an ICP monitor may be necessary. Check for edema and auscultate for murmurs.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Pulsus paradoxus:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
A pulsus paradoxus may signal cardiac tamponade — a life-threatening complication of pericardial effusion that occurs when sufficient blood or fluid accumulates to compress the heart. When you detect pulsus paradoxus, quickly take the patient’s other vital signs. Check for additional signs and symptoms of cardiac tamponade, such as dyspnea, tachypnea, diaphoresis, jugular vein distention, tachycardia, narrowed pulse pressure, and hypotension. Emergency pericardiocentesis to aspirate blood or fluid from the pericardial sac may be necessary. Then evaluate the effectiveness of pericardiocentesis by measuring the degree of pulsus paradoxus; it should decrease after aspiration.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Orthostatic hypotension:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If you detect orthostatic hypotension, quickly check for tachycardia, altered level of consciousness (LOC), and pale, clammy skin. If these signs are present, suspect hypovolemic shock. Insert a large-bore I.V. line for fluid or blood replacement. Take the patient’s vital signs every 15 minutes, and monitor his intake and output.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Decorticate posture:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Obtain vital signs and evaluate the patient’s level of consciousness (LOC). If consciousness is impaired, insert an oropharyngeal airway and take measures to prevent aspiration (unless spinal cord injury is suspected). Evaluate the patient’s respiratory rate, rhythm, and depth. Prepare to assist respirations with a handheld resuscitation bag or with intubation and mechanical ventilation. Also, institute seizure precautions.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Pulse pressure, widened:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ If the patient displays increased ICP, continually evaluate his neurologic status.
▪ Be alert for restlessness, confusion, unresponsiveness, or decreased LOC.
▪ Watch for subtle changes in the patient's condition.
Patient teaching
▪ Explain diagnostic tests, such as blood studies, computed tomography scan, and magnetic resonance imaging.
▪ Explain the underlying disorder and treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Pulsus paradoxus:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for an echocardiogram to visualize cardiac motion and to help determine the causative disorder.
▪ Monitor vital signs and frequently check the degree of paradox because an increase in the degree of paradox may indicate recurring or worsening cardiac tamponade or impending respiratory arrest in severe COPD.
▪ Provide respiratory treatments, such as chest physiotherapy, to avert the need for endotracheal intubation.
Patient teaching
▪ Teach the patient about the underlying disorder and its treatments.
▪ Explain self-care techniques to the patient with COPD, such as pursed-lip, diaphragmatic breathing; coughing and deep-breathing exercises; and proper use of home oxygen equipment.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Orthostatic hypotension [Postural hypotension]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor intake and output and weigh the patient daily.
▪ Elevate the head of the bed, and help the patient to a sitting position with feet dangling over the side of the bed; if tolerated, have him sit in a chair for brief periods.
▪ Evaluate the patient's need for assistive devices, such as a cane or walker.
▪ Prepare the patient for diagnostic tests, such as hemoglobin level and hematocrit, serum electrolyte and drug levels, urinalysis, 12-lead electrocardiogram, and chest X-ray.
Patient teaching
▪ Advise the patient to change his position gradually.
▪ Show the patient how to use the call bell and tell him to call for assistance when getting out of bed or a chair.
▪ Explain the importance of maintaining an adequate fluid intake.
▪ Explain prescribed medications and their adverse effects.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Blood pressure, decreased [Hypotension]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Check the patient's vital signs frequently to determine if low blood pressure is constant or intermittent.
▪ If blood pressure is extremely low, assist in the insertion of an arterial catheter to allow close monitoring of pressures; alternatively, a Doppler flowmeter may be used.
▪ Prepare the patient for laboratory tests, which may include urinalysis, routine blood studies, an electrocardiogram, and chest, cervical, and abdominal X-rays or computed tomography scans.
▪ Administer fluid, blood products, and medication as ordered to improve blood pressure.
Patient teaching
▪ Advise the patient with orthostatic hypotension to stand up slowly from a sitting or lying position.
▪ For the patient with vasovagal syncope, discuss how to avoid triggers.
▪ Emphasize the importance of dangling the feet and rising slowly when getting out of bed.
▪ Explain diagnostic tests and procedures.
▪ Explain the underlying disorder and treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Decorticate posture [Decorticate rigidity, abnormal flexor response]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Assess the patient frequently to detect subtle signs of neurologic deterioration.
▪ Monitor his neurologic status and vital signs every 30 minutes to 2 hours.
▪ Be alert for signs of increased ICP, including bradycardia, an increasing systolic blood pressure, and a widening pulse pressure.
Patient teaching
▪ Explain the signs and symptoms of decreased LOC and seizures to the patient and his family.
▪ Discuss the patient's and family's quality-of-life concerns.
▪ Explain to the family how to keep the patient safe, especially during a seizure.
▪ Explain to the patient or family his diagnosis and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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