hypotension pharm

Definition of Hypotension

• Hypotension is defined as a blood pressure lower than 90 over 60 millimeters of mercury (mmHg).
• Causes of hypotension can include:
  • Hypovolemia
  • Sepsis
  • Shock
  • Dehydration

Clinical Implications of Hypotension

• Decreased cardiac output associated with hypotension can lead to several symptoms:
  • Dizziness
  • Tachycardia (increased heart rate)
  • Pallor (pale skin)
  • Diaphoresis (sweating)
  • Blurred vision
  • Confusion
• Immediately addressing hypotension is critical for patient safety and management.

Patient Assessment

• If the patient is asymptomatic and their blood pressure is close to their baseline, continue to monitor.
• If the patient is symptomatic (e.g., experiencing chest pain, decreased level of consciousness, or dizziness), initiate certain interventions:

Priority Nursing Interventions

1. Ensure Patient Safety
   • If the patient is standing, have them sit or lay down to prevent falls.
2. Identify the Underlying Cause of Hypotension
   • Assess whether the patient has recently received medications that could cause hypotension, such as:
     • Antihypertensive medications
     • Narcotics
   • Evaluate if the patient is:
     • Bleeding
     • Dehydrated
     • Experiencing a vagal response
     • Suffering from orthostatic hypotension (standing up too quickly)
3. Notify the Provider
   • It's essential to communicate findings to the physician for appropriate orders.
   • Expected orders based on the underlying cause may include:
     • Intravenous (IV) fluids if dehydrated or bleeding
     • Blood products if indicated
     • An antidote for medications causing hypotension
4. Supportive Care for Specific Cases
   • If the patient experienced a vagal response, provide:
     • Supportive measures such as rest and deep breathing to allow the body to reset.
   • For orthostatic hypotension, actions may include:
     • Educating the patient to sit and stand slowly.
     • Possible medication orders to maintain higher blood pressure.
5. Fall Precautions
   • Always assume that the patient is at risk for falls until blood pressure stabilizes within normal limits.
   • Accompany the patient to the commode or bathroom as required.
6. Assess Oxygen Levels
   • Monitor pulse oximetry levels:
     • If low, administer oxygen via nasal cannula to increase SPO₂ levels.

Communication and Documentation

• Hypotension management should always be communicated effectively:
  • Notify the Registered Nurse (RN) or clinical instructor when in a clinical setting.
  • Stay with the patient when possible to monitor their condition.
  • In clinical settings, notify the provider if blood pressure continues to drop or symptoms worsen.
  • Be prepared for the need for a rapid response if conditions deteriorate further.