Orthostatic hypotension is a leading reason for falls in the elderly and people who have severe medical conditions. When a person stands up, there is a pooling of blood in the lower extremities. In some cases, the blood takes a bit longer to returns to the heart when moving from a supine, or lying down position to a sitting and standing position. This causes a person to become dizzy, thus increasing his chances for a dangerous fall. Your doctor may prescribe a series of orthostatic blood pressure readings to monitor the differences in your blood pressure as you change positions.
Ask the patient to lie down on the bed. Have the patient stay in this position for five minutes. After this amount of time, the patient’s blood pressure will have settled to his normal supine pressure. Place the blood pressure cuff on the patient’s upper arm between the elbow and the shoulder, making sure it fits snugly on the arm. The patient’s arm will need to be slightly bent. Look for an arrow on the cuff. It will tell you the exact position of placement.
Find the valve on the bulb that is used to tighten the blood pressure cuff. Turn the valve clockwise until it is tight. This will ensure the air enters the cuff and tightens it to the point required to read the systolic pressure, or top number of a blood pressure reading. Place the binaural, or ear tips of your stethoscope in your ears and place the wide end of the stethoscope, or chest piece against the patient’s skin on top of the brachial artery, located at the inside of the elbow. Pump the bulb until the sphygmomanometer reads 200, and then release the valve on the bulb very slowing, listening closely to hear the beating of the heart. The first beat you hear is going to indicate the systolic pressure, so it is very important to remember this number. Continue listening to the beating until it stops, making sure you watch the arrow on the sphygmomanometer. When the beating stops, the number on your sphygmomanometer will indicate the diastolic pressure. Therefore, if the beating started when the arrow pointed at 110, and the beating stopped at 60, your patient’s blood pressure is 110/60. Record this number on a piece of paper, so you can report your results to the doctor.
Have the patient sit up on the side of the bed. Ask him to sit there for five minutes. After five minutes, repeat the steps above. Record the blood pressure of the patient while sitting up. After recording this step, ask your patient to stand. Take his blood pressure while standing up and record the results. The patient’s blood pressure will usually display a difference in numbers between lying down, sitting and standing up, thus giving the physician valuable information to help him with his diagnosis.