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    Orthostatic hypotension: clinical review and case study

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    Authors
    Bailey, Rachael
    Mortimore, Gerri cc
    Affiliation
    University of Derby
    Issue Date
    2020-05-14
    
    Metadata
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    Abstract
    Transient loss of consciousness (TLOC) accounts for 3% of all attendance in emergency departments within the UK. More than 90% of TLOC presentations are due to epileptic seizures, psychogenic seizures or syncope. However, in England and Wales in 2002, it was estimated that 92000 patients were incorrectly diagnosed with epilepsy, at an additional annual cost to the NHS of up to £189 million. This article will reflect on the case study of a 54-year-old female patient who presented with a possible TLOC, and had a background of long-term depression. Differential diagnoses will be discussed, but the article will focus on orthostatic hypotension. Being diagnosed with this condition is independently associated with an increased risk of all-cause mortality. Causes of orthostatic hypotension and the pathophysiology behind the condition will be discussed, highlighting the importance of obtaining an accurate clinical history. This is extremely pertinent if a patient collapses in an NHS setting and this is witnessed by nurses because they can contribute to the history of the type of collapse, to aid diagnosis and correct treatment. In addition, nurses have a valuable role to play in highlighting polypharmacy to doctors, and non-medical prescribers, as a contributing factor to orthostatic hypotension is polypharmacy. It is therefore important to accurately distinguish TLOC aetiology, not only to provide appropriate management, but to also identify patients at risk of morbidity/mortality related to underlying disease.
    Citation
    Bailey, R., and Mortimore, G. (2020). 'Orthostatic Hypotension: clinical review and case study'. British Journal of Nursing, 29(9), pp. 506-511.
    Publisher
    Mark Allen Group
    Journal
    British Journal of Nursing
    URI
    http://hdl.handle.net/10545/624802
    DOI
    10.12968/bjon.2020.29.9.506
    Additional Links
    https://www.magonlinelibrary.com/loi/bjon
    https://www.magonlinelibrary.com/doi/full/10.12968/bjon.2020.29.9.506
    Type
    Article
    Language
    en
    ISSN
    0966-0461
    ae974a485f413a2113503eed53cd6c53
    10.12968/bjon.2020.29.9.506
    Scopus Count
    Collections
    School of Nursing and Professional Practice

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