Postural Vitals

[Rhonda V]

We have a provider at our clinic who routinely orders postual vital signs on patients who have been vomiting. A few of the nurses I work with (including myself) are not real sure what is the correct way to do them. Some say you should wait at least 1-2 minutes between laying, sitting, and standing while others say you should take the vitals as soon as you get the patient into position so that they don't have time to compensate. Also, do you repeat the pulse and BP each time on the same arm or does it matter? I thought that if you take the BP right away on the same arm that you'd get a false high reading since it was just taken. Any help with doing postural vitals would be appreciated.

Thank You :)

Rhonda

[TazziRN, RN]

Same arm. Wait 3 minutes in between each. If they compensate then they're not positive. The idea is to see if they're so dry that they CAN'T compensate.

[lna2rn]

I always get the pleasure of having to do these on all the patients on the unit who have them ordered twice a week. Here is how to do them: You must do them on the same side due to possible differences on the elasticity of blood vessels. You should give them a moment between positions to get accurate results. If the radial pulse is especially weak take an apical pulse to ensure it is accurate. If you have anymore questions let us know we will try to help.

[zacarias, ASN, RN]

I agree with the above. I usually wait 3-5 minutes. Postural blood pressures are particularly useful for people that have been in bed a while and you are first getting them up.

[elkpark]

Have you checked your hospital's Nursing Policy & Procedure manual? It should have a written policy defining what the established/accepted procedure is for your facility, and that's how you should all do it.

If there is no P/P for postural vitals in the manual, bring that to the attention of your nursing administration or ed department.

[rjflyn, ASN, RN]

Generally it is 2-3 mins between position changes. Also note pts signs and symptoms with the position changes, I have seen pts with no significant changes in VS but so lightheaded they almost fall.

It also pays to note to make sure the patient nows the difference between being dizzy and being lightheaded- alot don't. Even some nurses don't.

Rj