Acute orthostatic hypotension.

Acute orthostatic hypotension is a common occurrence during a patient's first experiences out of bed after surgery or a period of immobility. It is imperative that acute care nurses understand the dynamics of this phenomenon to provide effective preventive and supportive care for these patients. In this article are outlined recommendations for this care. Preventing acute orthostatic hypotension entails careful assessment of the status of the patient's sympathetic reflexes and assisting these reflexes to gain maximal control over peripheral vasoconstriction before the patient leaves bed. Supportive care during the patient's early experiences out of bed involves measures to reduce the likelihood of acute orthostatic hypotension, careful assessment of parameters that signal impending syncope, and immediate assistance for the patient who does experience it. On the patient's return to bed, evaluation of the patient's tolerance level assists in planning the patient's next venture out of bed.