B12 · Dizzy when standing up
Risk Breathing and circulation
Definition
Blood pressure drops on standing, so the person may feel faint or fall.- Dehydration
- blood pressure medicine
- long bed rest
- older age
- Light-headedness or darkening vision on standing
- holding on to furniture
- falls
📋 Scenario
An older man on a water tablet and a blood pressure tablet has been drinking little and has spent two days in bed.
Subjective (S): "I have not been drinking much and I have been in bed a lot."
Objective (O): Blood pressure 138/82 lying and 128/76 standing; pulse 76/min lying; dry lips; on blood pressure tablets; 2 days in bed; no dizziness reported.
Assessment tools for this scenario: CP-BREATH Breathing & Circulation Check CP-SKIN Skin & Wound Score
Validated scales to consider: NEWS2, SpO₂, ECG, Braden Scale, TIME wound chart
**CarePath diagnosis:** Dizzy when standing up related to dehydration, blood pressure medicine and long bed rest (risk factors); no signs of the problem are present yet.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Check lying and standing blood pressure. | Comparing lying and standing blood pressure detects a drop on standing, the early sign of this problem, before symptoms appear. |
| Have him sit on the bed edge before standing. | Sitting first lets blood pressure adjust gradually, since blood pools in the legs on standing after time in bed. |
| Rise slowly. | Rising slowly gives vessels time to tighten, preventing a sudden drop in blood flow to the brain. |
| Encourage fluids. | Drinking restores blood volume lost through poor intake and the water tablet, which supports a stable pressure. |
| Assist when walking. | Helping him walk prevents a fall if he becomes light-headed. |
**Expected outcomes**
- Within 48 hours: no fainting or falls and standing blood pressure within 20 mmHg of lying.
- Patient demonstrates slow position changes and says why.
**Linking the data to the diagnosis**
This is a risk statement: the problem has not occurred yet. The older man takes a water tablet and a blood pressure tablet, has been drinking little and has spent two days in bed. He has dry lips and reports no dizziness. Blood pressure is 138/82 lying and 128/76 standing, a fall of 10 mmHg, so the drop is not yet significant. The diagnosis rests on risk factors, not on found signs. The plan aims for no fainting or falls in 48 hours, standing pressure within 20 mmHg of lying, and the patient showing slow position changes and saying why.
CarePath diagnosis
Dizzy when standing up related to dehydration, blood pressure medicine and long bed rest (risk factors); no signs of the problem are present yet.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Check lying and standing blood pressure. | Comparing lying and standing blood pressure detects a drop on standing, the early sign of this problem, before symptoms appear. |
| 2. Have him sit on the bed edge before standing. | Sitting first lets blood pressure adjust gradually, since blood pools in the legs on standing after time in bed. |
| 3. Rise slowly. | Rising slowly gives vessels time to tighten, preventing a sudden drop in blood flow to the brain. |
| 4. Encourage fluids. | Drinking restores blood volume lost through poor intake and the water tablet, which supports a stable pressure. |
| 5. Assist when walking. | Helping him walk prevents a fall if he becomes light-headed. |
Expected outcomes
- Within 48 hours: no fainting or falls and standing blood pressure within 20 mmHg of lying.
- Patient demonstrates slow position changes and says why.
Linking the data to the diagnosis
This is a risk statement: the problem has not occurred yet. The older man takes a water tablet and a blood pressure tablet, has been drinking little and has spent two days in bed. He has dry lips and reports no dizziness. Blood pressure is 138/82 lying and 128/76 standing, a fall of 10 mmHg, so the drop is not yet significant. The diagnosis rests on risk factors, not on found signs. The plan aims for no fainting or falls in 48 hours, standing pressure within 20 mmHg of lying, and the patient showing slow position changes and saying why.