A nurse in a transitional care unit is assisting a 75-year-old client out of bed for the first time in the morning. Due to normal age-related cardiovascular changes, this client is at increased risk for orthostatic hypotension. Place the following nursing actions in the correct sequence to safely mobilize the client.
- 1Raise the head of the bed to an upright angle.
- 2Assist the client to pivot and sit on the edge of the bed.
- 3Have the client dangle their legs for several minutes.
- 4Assess the client for reports of dizziness or lightheadedness.
- 5Support the client in slowly transitioning to a standing position.
Cevap
The correct sequence for safe mobilization is: Raise the head of the bed, assist the client to sit on the edge, have them dangle their legs, assess for dizziness, and finally support them to a standing position.
Age-related changes in the cardiovascular system include decreased baroreceptor sensitivity, which delays the body's ability to maintain steady blood pressure when changing positions. To prevent orthostatic hypotension and subsequent falls, position changes must be gradual. The client should first be elevated in bed, then pivoted to sit, allowed to dangle and stabilize, assessed for symptoms, and finally assisted to stand.
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Anahtar Kavram
Orthostatic Hypotension Prevention in Older Adults