Editing Fundamentals of Nursing – RN Practice Questions (section)

==Question 7==
Which findings should the nurse report as indicating a positive orthostatic blood pressure test? '''Select all that apply.'''
# A fall in systolic blood pressure from 132 to 108 millimeters of mercury on standing.
# A fall in diastolic blood pressure from 78 to 74 millimeters of mercury on standing.
# The patient reports dizziness and blurred vision on standing.
# A rise in heart rate from 76 to 82 beats per minute on standing.
# A fall in systolic blood pressure from 140 to 128 millimeters of mercury on standing.
# A fall in diastolic blood pressure from 84 to 72 millimeters of mercury on standing.

'''Answer:''' 1, 3, and 6.

''Rationale:'' Orthostatic hypotension is defined by a drop of at least 20 millimeters of mercury in systolic pressure or at least 10 millimeters of mercury in diastolic pressure within three minutes of standing, or by symptoms such as dizziness, lightheadedness, or visual changes. Option 1 is a 24 point systolic drop and option 6 is a 12 point diastolic drop, both qualifying. Option 3 is symptomatic and clinically significant regardless of the numbers. Option 2 is a 4 point drop and option 5 is a 12 point systolic drop, neither of which meets the systolic or diastolic threshold. Option 4 is a normal compensatory heart rate response.