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Assessing for Orthostatic Hypotension (102.099)

Assessing for Orthostatic Hypotension (102.099) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Patient Assessment

102.099

1
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: ASSESSING FOR ORTHOSTATIC HYPOTENSION

Effective Date: March, 2002 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed October, 2003 March, 2005 February, 2008 October 2011 October 2012


PURPOSE:
To provide guidelines for the measurement of orthostatic hypotension in patients at
University of Wisconsin Medical Foundation (UWMF) or Department of Family Medicine (DFM) clinics.

DEFINITION:
Orthostatic hypotension or postural hypotension is a drop in blood pressure that occurs when the person changes
from a horizontal to a vertical position. A drop in blood pressure of approximately 20 mm Hg in systolic
pressure and 10 mm Hg in diastolic pressure with symptoms such as dizziness, pallor, or fainting.

POLICY:
The clinical staff will utilize the following guidelines to measure an orthostatic blood pressure in a UWMF or
DFM patient.

SUPPLIES: Provider’s order, Pen, patient’s record, stethoscope, Sphygmomanometer with cuff

PROCEDURE:


1. Check provider’s order and clarify any inconsistencies.

2. Gather appropriate portable blood pressure equipment; correct cuff size for patient.

3. Introduce yourself to the patient and identify the patient by verifying name and date of birth.

4. Provide good light and privacy.

5. Explain procedure and the purpose of needing an orthostatic blood pressure.

6. Be aware also of the signs and symptoms of low blood pressure (hypotension): dizziness, mental confusion,
restlessness, pale or cyanotic (dusky) skin and mucous membranes, and cool mottled skin over the
extremities.

7. Wash hands.

8. Take patient’s blood pressure and pulse rate as listed in the chart below. Assist patient as needed.




BP /P
Reading
Position of
patient
Minutes in position before taking
blood pressure and pulse
Record any patient
symptoms
First Lying 1-2 minutes Dizziness, pallor or fainting
Second Sitting 1-2 minutes Dizziness, pallor or fainting
Third Standing 1-2 minutes Dizziness, pallor or fainting

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9. Documentation:
Within Vitals section, use the Extended Vitals area to document the results of the blood pressure and
pulse rate, the arm used, cuff size and position of patient.
Within the Progress Note area use the smart phrase “.extvitalsorth”. Also document how the patient
tolerated the procedure, noting any possible symptoms of dizziness, pallor, fainting, or lightheadedness.


REVISED BY: LaVay Morrison, RN, BSN, Clinical Staff Educator, 2012
REVIEWED BY:
WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support

REFERENCES:
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St.
Louis, MO: Mosby Elsevier.
Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams
& Wilkins.


AUTHORIZED BY: Richard Welnick, MD, Medical Director, UWMF Ambulatory Clinic Operations
Sandra A. Kamnetz M.D., Vice Chair, Department of Family Medicine


_______________________________________________________________________________
Medical Director, UWMF

________________________________________________________________________________
Vice Chair, Department of Family Medicine