👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: postural low blood pressure · dizziness on standing · head rush when standing
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Use this quick-reference guide to spot, treat, and prevent Orthostatic Hypotension on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Define
↓SBP 20 / ↓DBP 10 on standing
+ ↑HR within 3 min
⚠️ Cause
Dehydration, blood loss
Antihypertensives, diuretics
Prolonged bed rest
🎓 Teach
Rise slowly, dangle legs
↑ fluids, ↑ salt if ok
Compression stockings
🚩 Report
Dizziness, syncope → fall risk
📚 Orthostatic Hypotension — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Orthostatic hypotension is a drop in blood pressure when moving from lying or sitting to standing, defined as a fall of at least 20 mmHg systolic or 10 mmHg diastolic within three minutes of standing. It causes dizziness, lightheadedness, and increases fall risk. Common causes include dehydration, blood loss, antihypertensive medications, and prolonged bed rest.
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Key points
Understand these first
Defined as a drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing.
Causes dizziness, lightheadedness, blurred vision, and syncope, raising fall risk.
Common causes: volume depletion (dehydration/bleeding), antihypertensives, diuretics, and prolonged bed rest.
Often accompanied by a compensatory rise in heart rate, especially with volume loss.
Measure BP and pulse lying, sitting, and standing to assess for orthostatic changes.
Primary nursing concern is fall prevention through safe, gradual position changes.
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Nursing priorities
What to do, in order
Measure orthostatic vital signs (lying, sitting, standing) and document changes.
Teach the patient to change positions slowly and dangle legs before standing.
Implement fall precautions and assist with ambulation as needed.
Address underlying causes: assess hydration, review medications, and replace fluids/volume as ordered.
Encourage adequate fluid intake and compression stockings when appropriate.
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Red flags — report now
Escalate immediately
Syncope or a fall with injury requires immediate assessment.
Persistent hypotension with tachycardia and signs of shock may indicate ongoing bleeding or volume loss.
Severe dizziness with chest pain or neurologic symptoms needs urgent evaluation.
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Labs & values
Numbers to know
Hemoglobin 12-18 g/dL and hematocrit 37-52% (low values suggest blood loss as a cause)
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Patient teaching
What patients must know
Rise slowly: move from lying to sitting, dangle the legs, then stand.
Stay well hydrated and avoid alcohol and prolonged standing in heat.
Wear compression stockings if recommended to improve venous return.
Report frequent dizziness or fainting and review medications with the provider.
❓ Orthostatic Hypotension: NCLEX FAQs
What are the priority nursing interventions for Orthostatic Hypotension?
Measure orthostatic vital signs (lying, sitting, standing) and document changes. Teach the patient to change positions slowly and dangle legs before standing. Implement fall precautions and assist with ambulation as needed. Address underlying causes: assess hydration, review medications, and replace fluids/volume as ordered.
What are the warning signs of Orthostatic Hypotension a nurse must report?
Syncope or a fall with injury requires immediate assessment. Persistent hypotension with tachycardia and signs of shock may indicate ongoing bleeding or volume loss. Severe dizziness with chest pain or neurologic symptoms needs urgent evaluation.
What do I need to know about Orthostatic Hypotension for the NCLEX?
Defined as a drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing. Causes dizziness, lightheadedness, blurred vision, and syncope, raising fall risk. Common causes: volume depletion (dehydration/bleeding), antihypertensives, diuretics, and prolonged bed rest. Often accompanied by a compensatory rise in heart rate, especially with volume loss.
What patient teaching is important for Orthostatic Hypotension?
Rise slowly: move from lying to sitting, dangle the legs, then stand. Stay well hydrated and avoid alcohol and prolonged standing in heat. Wear compression stockings if recommended to improve venous return. Report frequent dizziness or fainting and review medications with the provider.
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Quick Tip
Defined as a drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing.