The scenario
An 85-year-old male has noticed over the past few days that he feels palpitations in his chest and sometimes feels light-headed and dizzy. Objective findings confirm that the heart rate is elevated and you note an irregular rhythm. Orthostatic blood pressure readings include: lying 135/90, sitting 120/80, standing 100/60. The client becomes dizzy and light-headed as you have him go from a sitting to a standing position while taking the blood pressure.
When the average male goes from a sitting position to a standing position, there is 300 to 800 mls of blood that pools in the lower extremities. The body maintains blood pressure during position changes by a range of complex manipulations of the cardiovascular system: sensitive cardiac, vascular, neurologic, muscular, and neurohumoral responses must occur quickly. If any of the responses are slow, the result could be a drop in blood pressure, that would result in nervous system hypo perfusion. This may result in, feelings of weakness, nausea, headache, neck ache, lightheadedness, dizziness and blurred vision. …show more content…
As with the scenario above the drop of systolic blood pressure from lying to sitting to standing is within the definition used for orthostatic hypotension. The definition of orthostatic hypotension is defined as a drop in systolic BP of 20 mm Hg or more from the supine to the standing position at 3 minutes, a drop in diastolic BP of 10 mm Hg or more, or both, Bradley, Davis (2003). The physiological alterations in the senior citizen, that exacerbate orthostatic blood pressure changes, include a loss of baroreceptor responsiveness. The baroreceptor is primarily responsible for maintaining blood pressure, on changing position from lying to sitting to standing. These physiological alterations can be caused