Nursing Care Plan for Hypotension
Also searched as: low blood pressure, orthostatic hypotension, postural hypotension
Blood pressure low enough to cause symptoms or to signal a problem; for most adults that means a reading below 90/60 mmHg. Some people run low all the time and it is normal for them, while a sudden drop can mean the heart, brain and other organs are not getting enough blood. The form students meet most often is orthostatic hypotension, a drop on standing that raises the risk of falls, especially in older adults. Nursing care measures it correctly, prevents falls, treats the cause, and escalates any sign of shock.
🎓 Educational example. Adapt to your patient and have your instructor review it. Not medical advice.
⚠️ Time-critical condition. Hypotension can deteriorate quickly. This page is a study example, not a clinical protocol: at the bedside follow your facility's policy, escalate to the provider or rapid response team, and never delay treatment to consult a study resource.
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What do you assess in the Hypotension care plan?
- Subjective: dizziness or lightheadedness, especially on standing or after a meal, blurry vision, weakness or tiredness, nausea, confusion, fainting; review medicines (blood pressure medicines, diuretics, nitrates, some antidepressants), fluid intake, and recent bleeding or vomiting
- Objective: blood pressure below 90/60 mmHg or well below the patient's usual reading; orthostatic vital signs (a drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing after at least 5 minutes lying down); heart rate, skin and mental status; signs of shock such as cold, sweaty skin, rapid breathing, a bluish skin tone and a weak, rapid pulse
Which nursing diagnoses apply to Hypotension?
Risk factors: dizziness on standing, positive orthostatic vital signs, older age, blood pressure medicines or diuretics
Risk factors: blood pressure below 90/60 mmHg or below baseline, dizziness, confusion, weakness
As evidenced by: low fluid intake, thirst, dry mucous membranes, rising heart rate
What are the goals and expected outcomes for Hypotension?
Each goal below follows the SMART format: specific, measurable, achievable, relevant, time-bound.
- The patient will remain free of falls and injury during the stay, changing position in stages with help as needed.
- The patient's blood pressure will stay at or above the target the provider set, and the patient will report no dizziness on standing by discharge.
- Before discharge, the patient will demonstrate rising in stages (lying, sitting, standing) and name the warning signs to report.
What are the nursing interventions for Hypotension, and why?
| Intervention | Rationale |
|---|---|
| Measure orthostatic vital signs as ordered: blood pressure and pulse after at least 5 minutes lying down, then within 3 minutes of standing, and sit the patient down if symptoms start. | A sustained drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing defines orthostatic hypotension. |
| Put fall precautions in place: teach changing position in stages from lying to sitting to standing, have the patient sit on the edge of the bed before standing, assist with walking, and keep the call light in reach. | Falls are the main source of harm from orthostatic hypotension, and changing position in stages is a first-line way to reduce orthostatic stress. |
| If the patient becomes symptomatic, have them sit or lie down at once and raise the feet above heart level, then recheck blood pressure and notify the provider. | MedlinePlus gives this as the first step when low blood pressure causes symptoms. |
| Review the medication list with the provider and pharmacist (blood pressure medicines, diuretics, nitrates, alpha-blockers, some antidepressants and antipsychotics), and hold or give doses only as ordered. | Medicines are a frequent cause, especially in older adults; the provider may change the dose or switch the drug, and patients should not stop a medicine on their own. |
| Support fluid intake and give IV fluids as ordered; apply compression stockings and raise the head of the bed when ordered. | Fluids correct dehydration, compression stockings keep blood from pooling in the legs, and sleeping with the head of the bed raised can ease daytime orthostatic symptoms. |
| Escalate immediately for signs of shock: cold, sweaty skin, rapid breathing, a bluish skin tone, a weak and rapid pulse, new confusion or fainting. | A severe drop starves organs of oxygen and is a medical emergency that needs IV fluids or medicines to raise blood pressure. |
How do you evaluate the Hypotension care plan?
- No falls or injury; patient rises in stages
- Blood pressure at or above target, dizziness on standing resolved or reduced
- Medicine causes reviewed with the provider
- Patient states the warning signs and when to call for help
Where do these Hypotension recommendations come from?
- NHLBI: Low Blood Pressure
- MedlinePlus: Low blood pressure
- NCBI Bookshelf (StatPearls): Orthostatic Hypotension
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Build a care plan freeWhich nursing diagnoses are used in Hypotension?
Hypotension care plan: FAQ
What is the nursing diagnosis for Hypotension?
Common nursing diagnoses include: Risk for falls related to drops in blood pressure on standing; Risk for ineffective tissue perfusion related to low blood pressure; Deficient fluid volume (when dehydration is the cause) related to low intake, vomiting, bleeding or diuretic therapy. Choose the one your patient's assessment data supports.
What are nursing interventions for Hypotension?
Key interventions: Measure orthostatic vital signs as ordered: blood pressure and pulse after at least 5 minutes lying down, then within 3 minutes of standing, and sit the patient down if symptoms start.; Put fall precautions in place: teach changing position in stages from lying to sitting to standing, have the patient sit on the edge of the bed before standing, assist with walking, and keep the call light in reach.; If the patient becomes symptomatic, have them sit or lie down at once and raise the feet above heart level, then recheck blood pressure and notify the provider., each paired with a rationale.
Can I use this care plan for my assignment?
Use it as a study example and starting draft. Always adapt it to your specific patient and have it reviewed by your instructor. This is an educational tool, not medical advice.
For nursing education only, NOT medical advice and not a clinical decision-making tool. Nothing here should be used to assess, diagnose, or treat any real patient. Care plans and answers are unverified study drafts to review with your instructor or a licensed clinician and adapt to the individual patient and your institution’s protocols before any use.
Educational content based on standard nursing practice; not medical advice and not affiliated with NANDA-I/NIC/NOC. Always follow your institution's protocols and your instructor's guidance.