Blood pressure drops upon standing?

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Specializes in ICU, Intermediate Care, Progressive Care.

I'm a 1st semester nursing student and we've just had our first test, one week in. I did good as a whole, but one of the questions really stuck out to me and I want to see if I'm remembering my Anatomy and Physiology right or what. The question was something to the effect of:

For which of these client conditions would you notify the physician?

A. A temperature of 98.6

B. something else I don't remember

C. blood pressure drops upon standing

D. decrease in body temp temperature following diaphoresis

Well, I knew A and B were both normal conditions, so it was between C and D. I didn't know what diaphoresis was, so I wasn't sure if that was a normal finding or not. I considered C, but I remember doing a lab in physiology in which we measured someone's blood pressure sitting down, then immediately upon standing, then one minute after standing. The results were that your blood pressure drops rapidly upon standing up due to all the blood rushing downwards, then re-regulates itself within a minute or so. So I decided that BP dropping upon standing would be a normal finding. That left my only choice as D, a decrease in body temperature following diaphoresis.

Aftrerwards I saw that I had gotten it wrong, and that the answer was C. I discussed it with my instructor afterwards, who explained that diaphoresis is sweating, so I understand that D is not the right answer, and she said they might throw the question out because we're only one week into the course and haven't had specific nursing terms like diaphoresis. Apparently with C, they were looking for orthostatic hypotension, which I kind of understand, too, but if I'm remembering my physiology right, maybe they should have written it as "blood pressure drops upon standing and does not return to normal within x amount of time."

Any insight?

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C. blood pressure drops upon standing Orthostatic hypotension- common, usually not a big deal. Just make sure they don't fall

D. decrease in body temp temperature following diaphoresis (sweating) Sounds a little more serious to me. I guess they're just saying it's normal for this to happen after exercise or in excessive heat, but if neither is mentioned in the stem of the question, the sweating then temp drop could sound like cardio symptoms.

Bad question!

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Specializes in ICU, Intermediate Care, Progressive Care.

I think their rationale was that diaphoresis/sweating is *meant* to lower body temperature. I just figure any majorly noticeable loss of body temperature is something I'd report to the physician, but then again, I've only got one week of real nursing school under my belt, heh.

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Were there mentions of exercise or heat in the question stem?

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Specializes in ICU, Intermediate Care, Progressive Care.

Nope. Just "which of these findings in a client would you report to the PCP" basically.

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Questions like these drive me insane!! Just like you're pointing out, there really is no right answer!!! You can have rationales for everything!!!!! UGH!!

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D. None of the above.

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Specializes in Ortho, Neuro, Detox, Tele.

ok as a staff nurse, I would say C. I would want a patient to sweat if they had say a fever of 100...and needed to bring it down, and it is a sign of breaking fever. Orthostatic hypotension can be a result of not enough blood/fluid volume. either dehydration or low H&H can be a cause. Pt usually needs fluid bolus, then they are usually ok.

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Oops lol. My answer should've been E.

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Specializes in Progressive, Intermediate Care, and Stepdown.

If a pt is already at a fluid deficit. Generally, the main concern is a deficit within the intravascular space ( aka ECF, blood volume, circulatory volume, blood, plasma, different terms that are generally describing the same are but some people use different terms). If they stand, the already low BP one would have r/t the fluid deficit, would influence the pressure exerted against the BP cuff. The influence would be gravity pulls the fluids downward, naturally, and thus there would be less pressure exerted against the cuff, thus orthostatic hypotension (Abnormally low BP while standing) Usually, a 20mmHg drop is considered significant.

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I'm a 1st semester nursing student and we've just had our first test, one week in. I did good as a whole, but one of the questions really stuck out to me and I want to see if I'm remembering my Anatomy and Physiology right or what. The question was something to the effect of:

For which of these client conditions would you notify the physician?

A. A temperature of 98.6

B. something else I don't remember

C. blood pressure drops upon standing

D. decrease in body temp temperature following diaphoresis

Well, I knew A and B were both normal conditions, so it was between C and D. I didn't know what diaphoresis was, so I wasn't sure if that was a normal finding or not. I considered C, but I remember doing a lab in physiology in which we measured someone's blood pressure sitting down, then immediately upon standing, then one minute after standing. The results were that your blood pressure drops rapidly upon standing up due to all the blood rushing downwards, then re-regulates itself within a minute or so. So I decided that BP dropping upon standing would be a normal finding. That left my only choice as D, a decrease in body temperature following diaphoresis.

Aftrerwards I saw that I had gotten it wrong, and that the answer was C. I discussed it with my instructor afterwards, who explained that diaphoresis is sweating, so I understand that D is not the right answer, and she said they might throw the question out because we're only one week into the course and haven't had specific nursing terms like diaphoresis. Apparently with C, they were looking for orthostatic hypotension, which I kind of understand, too, but if I'm remembering my physiology right, maybe they should have written it as "blood pressure drops upon standing and does not return to normal within x amount of time."

Any insight?

The question didn't say that the blood pressure dropped and then readjusted after standing....it said it dropped upon standing. Assuming that it then adjusted is reading in to the question....these questions need to be answered with just the information given to you.

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