The nurse is moving a patient, recovering from a 2nd to 4th thoracic vertebral injury, from a lying to a sitting position. Which of the following should the nurse do to prevent the onset of orthostatic hypotension?

Question

1. swing legs to the side of the bed and lift the torso to a sitting position while supporting the patient from behind
2. remove abdominal binder prior to moving to a sitting position
3. limit the use of compression stockings when changing position
4. gradually raise the head of the bed and assess tolerance

Answer 1

4

Rationale: Chronic peripheral vasodilation causes orthostatic hypotension, particularly for patients with injuries at T6 or above. Chronic vasodilation in combination with a quick position change results in a loss of consciousness. Therefore, initial attempts to mobilize the patient are done slowly. Gradually raise the head of bed, and assess patient tolerance to these position changes. Feet are dangled on the side of the bed prior to movement out of bed to a chair. The patient should be wearing an abdominal binder and compression hose not having them removed prior to moving from a lying to a sitting position.