Here are interventions and educational strategies for patients who suffer from orthostatic intolerance, such as the elderly or patients on medications that promote orthostasis, suggested by Nina M. Fielden, MSN, RN, CEN, an ED clinical nurse specialist at The Cleveland Clinic Foundation:
- Have your patient change position gradually from supine to dangling to standing, then walking in place before walking away from the bed.
- Talk to your patients about how they are feeling to detect signs of dizziness. Lie them back down upon signs of insufficient cerebral perfusion.
- Help patients perform leg exercises in bed before sitting up and while sitting on the edge of the bed.
- Elevate the head of the bed 30-45 degrees.
- Encourage your patient to take slow deep breaths and to avoid bearing down, preventing a potential vagal response. Consider laxatives or stool softeners to avoid constipation.
- Keep room temperatures cool.
- Tell patients to consider wearing knee-length elastic stockings.
- Avoid showering, bathing, shaving, or any major task for at least 30 minutes after arising, and avoid hot showers and baths.
- Encourage your patient to drink at least six to eight glasses of water to prevent dehydration and to eat more small meals a day rather than large ones.
- Instruct patients to avoid bending over at the waist to pick up items from the floor or to reach something on a low shelf. Instead, encourage them to bend with the knees and keep the head above the level of the heart.
- Tell patients to consider a bedside commode or urinal if they get up during the night to use the bathroom.
- Instruct your patients on the orthostasis side effects of their medications and alcohol.
Here are interventions and educational strategies for patients who suffer from orthostatic intolerance, such as the elderly or patients on medications that promote orthostasis.
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