Hypotension

Definition

Hypotension is a blood pressure below normal, typically less than 90/60 mmHg, often symptomatic. Causes range from benign (dehydration) to life-threatening (shock).

Types

• Orthostatic: Drop greater than 20 systolic or 10 diastolic within 3 minutes of standing.
• Absolute: Persistent low BP.
• Shock: Hypotension with organ hypoperfusion.

Causes

Hypovolemia, sepsis, cardiogenic shock, anaphylaxis, vasovagal syncope, neurogenic shock, medications (antihypertensives, opioids), endocrine (Addison's, hypothyroidism).

Nursing Interventions

Assess for hypoperfusion (tachycardia, cool skin, low urine output, altered LOC). IV fluids (crystalloids first-line), vasopressors (norepinephrine) for shock (trendelenburg controversial). Modified (legs up) preferred. Teach orthostatic precautions: rise slowly, dangle legs.

NCLEX Relevance

Symptomatic hypotension = emergency. Orthostatic precautions prevent falls.