orthostatic vital signs question

[ViolinTreble]

I understand that a patient is positive orthostatic if their bp drops when they are standing or pulsae rate goes up but what does it mean if their bp goes up when they are standing. For example laying sbp 130 sitting sbp 145 then standing sbp 175?/I]

[scottaprn]

Orthostatic hypertension. No one is entirely sure but probably alpha-andrenic in nature. Actually pretty common in elderly patients (which makes you wonder why we don't take it stsnding in elderly people since they do spend time on their feet but I digress).

When you see it in a patient think about the following things- fluid overload, venous pooling of the lower extremities, renal artery stenosis, inflammation of the aorta and peripheral artery disease. Then again sometimes we don't know why it happens.

Hope that helps

[taggart84]

Great question and response. What would the pt teaching be for ortho static hypertension? For hypo I educate on slow position changes, fall precautions and emergency plan. I've not cared for a patient with the opposite... Or maybe I've just never discovered it because I only do ortho bp's when ordered for hypo.

[scottaprn]

Taggart84,

I would make sure the person was educated on signs and symptoms of peripheral artery disease. Also importance of regimine for blood pressure control, cholesterol and lipids and aspirin.

[ViolinTreble]

Thanks so much!