The nurse assesses that the 86-year-old patient is experiencing orthostatic hypotension when assessments indicate: (Select all that apply.)

a drop of 15 to 20 mm Hg from baseline when changing position.

dizziness upon rising to a standing position.

blurred vision.

syncope.

Answer and Explanation

Correct Answer : A,B,C,D

A.   A significant drop in blood pressure when standing (typically greater than 20 mm Hg systolic or 10 mm Hg diastolic) is a hallmark of orthostatic hypotension.
B.   Dizziness upon standing is a classic symptom of orthostatic hypotension due to decreased blood flow to the brain.
C.   Blurred vision can also result from decreased blood flow and is a common symptom of orthostatic hypotension.
D.   Syncope (fainting) can occur as a result of orthostatic hypotension when the brain does not receive enough oxygenated blood due to the drop in blood pressure.

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Correct Answer is B

Explanation

A. While understanding the onset of symptoms is important, the patient's occupation might provide more insight into potential environmental or work-related exposures that could explain the symptoms, such as chronic exposure to irritants or pollutants.

B. The occupation is highly relevant, as it may help identify occupational hazards, such as exposure to chemicals, dust, or other respiratory irritants, which could be contributing to the symptoms.
C. Although a headache could be related to fatigue or other symptoms, it is not the most relevant question in this case.
D. Abdominal pain is less likely to be the focus when the primary symptoms are chest congestion and a cough, which suggest respiratory involvement.

A. Kussmaul's respirations. B. Cheyne-Stokes respirations. C. Biot's respirations. D. Hyperventilation.

Correct Answer is B

Explanation

A. Kussmaul's respirations are rapid, deep, and labored breaths often seen in metabolic acidosis, which does not match the pattern described.
B. Cheyne-Stokes respirations are characterized by a pattern of deep and fast breathing followed by periods of apnea. This pattern is seen in patients with severe conditions like heart failure or brain injury.
C. Biot's respirations are irregular, but the cycle does not have a distinct pattern of fast, slow, and apnea periods.
D. Hyperventilation refers to an increased rate of breathing but does not involve the cycles of deep, slow, and apneic phases characteristic of Cheyne-Stokes.

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