Which assessment helps confirm orthostatic changes in an elderly patient presenting with dizziness?

Which assessment helps confirm orthostatic changes in an elderly patient presenting with dizziness?

• A. Heart rate
• B. Blood pressure response to standing
• C. Urine output
• D. Respiratory rate

Answer: (B)

Assessing orthostatic changes centers on how blood pressure responds when a person moves from lying down to standing. In older adults with dizziness, orthostatic hypotension can occur because gravity reduces venous return and the body’s compensatory mechanisms may be slow or blunted. To confirm, measure blood pressure and heart rate after the patient has been supine for several minutes, then again after standing for about 1 to 3 minutes. Look for a drop in systolic pressure of 20 mmHg or more, or a drop in diastolic pressure of 10 mmHg. The heart rate may rise as compensation, but the essential clue is the BP decline. Urine output or respiratory rate don’t directly assess orthostatic changes.

Assessing orthostatic changes centers on how blood pressure responds when a person moves from lying down to standing. In older adults with dizziness, orthostatic hypotension can occur because gravity reduces venous return and the body’s compensatory mechanisms may be slow or blunted. To confirm, measure blood pressure and heart rate after the patient has been supine for several minutes, then again after standing for about 1 to 3 minutes. Look for a drop in systolic pressure of 20 mmHg or more, or a drop in diastolic pressure of 10 mmHg. The heart rate may rise as compensation, but the essential clue is the BP decline. Urine output or respiratory rate don’t directly assess orthostatic changes.