Syncope (fainting) is a loss of consciousness due to the sudden decline of blood flow to the brain. There are several types of syncope, such as vasovagal syncope, carotid sinus syncope, and situational syncope. Vasovagal syncope is triggered by emotional stress, pain, the sight of blood, trauma or prolonged standing. Carotid sinus syncope occurs when there is constriction of the carotid artery. Situational syncope happens during urination, defecation, coughing, or gastrointestinal stimulation. Textbook signs and symptoms include dizziness, lightheaded, nauseous, cold, and clammy.
Syncope can also be a symptom of heart disease, abnormalities, and neurological disorders. Complications that occur due to syncope include: reduced level of consciousness and falls. If an older adult falls, complications such as, broken hips or limbs may result. Precaution should be taken for a person with syncope to decrease the risk of injury to the individual. Assessment priorities include: monitoring vital signs, fluid and electrolyte balance, and blood work. Nursing Diagnosis/ Interventions: Risk for Falls * Complete a fall-risk assessment for older adults in acute care.
Recognize that risk factors for falling include recent history of falls, confusion, depression, altered elimination patterns, cardiovascular and respiratory disease, hypotension, dizziness, and altered mobility. * Assess the client for the ability to supine to sit, sit supported and unsupported, standing, walking and turning around, and transferring. * Assess lab results and signs and symptoms of infection, dehydration and hypotension. If the client has hypertension, anti-hypertensives may be the result. * Encourage the client to wear glasses and use walking aids when ambulating.
* Make sure the client has a fall risk hand band on while under care in the hospital facility. * Teach the client the importance of using her prosthetic limb. * Refer her to physical therapy for the correct usage of her prosthetic limb. * Teach the client the importance of living in a home free of clutter such as slippery floors, scattered rugs, unleveled stairs or furniture. References: Ackley, B. , Ladwig, G. (2011). Nursing Diagnosis Handbook. An Evidence based Guide to Planning Care. Elsevier. pp. 355-361.