Untitled Quiz

Hypotension

• Low blood pressure means the pressure of blood circulating in the body is lower than what is considered normal.
• Normal systolic pressure is 110-129 mmHg and diastolic is 70-84 mmHg.
• Grade I (Mild) Hypotension: 90-109 mmHg systolic and 60-69 mmHg diastolic.
• Grade II (Moderate) Hypotension: 70-89 mmHg systolic and 50-59 mmHg diastolic.
• Grade III (Severe) Hypotension: 40-49 mmHg systolic and 50-69 mmHg diastolic.
• Extremely Severe Hypotension: <40 mmHg systolic and and <50 mmHg diastolic.

Types of Low Blood Pressure

• Orthostatic hypotension.
• Postprandial hypotension (PPH).
• Neural mediated hypotension (neurogenic orthostatic hypotension or vasovagal syncope).

Orthostatic Hypotension

• Systolic blood pressure decreases by at least 20 mmHg or diastolic blood pressure decreases by at least 10 mmHg within three minutes of standing.
• Common symptoms include feeling light-headed, dizzy, fainting, or blurred vision.

Causes of Orthostatic Hypotension

• Nervous system diseases, such as neuropathy.
• Prolonged bed rest.
• Dehydration.
• Irregular heart beat (heart arrhythmia).

Orthostatic Hypotension Management

• Slow changes in position to avoid falling.
• Wear stockings to increase venous return.
• Avoid temperature extremes.
• Schedule activities for before meals and in the afternoon.
• Avoid heavy lifting.
• Use a gradual staging approach when changing from supine to standing position.
• Incorporate breathing exercises.
• Perform isometric lower-extremity exercises in bed.
• Water and reclining exercises are helpful.
• Use compression garments to decrease venous pooling.
• Monitor blood pressure before, during, and after exercise.
• Get plenty of fluids.
• Limit or avoid alcohol.
• Increase salt in the diet only after consulting with a health care provider.

Postprandial Hypotension (PPH)

• A significant drop in blood pressure after eating.
• Common in elderly patients with autonomic system dysfunction.
• Occurs in approximately one-third of patients with diabetes mellitus and the majority of patients with Parkinson’s disease (PD).
• Also seen in patients with paraplegia, Alzheimer’s disease, heart failure, and hypertension.
• Diuretics like furosemide can increase the postprandial blood pressure drop.

PPH Management

• Educate patients about the risk of falling after eating.
• Instruct patients to remain in a supine position after meals.
• Advise patients to avoid alcohol with meals.
• Ensure adequate hydration.
• Encourage frequent small meals instead of large meals.
• Reduce the amount of carbohydrates in meals.
• Serve meals at colder temperatures.
• Consider coffee drinking with a meal.
• Encourage gradual exercise and walking after meals.