What is the standard procedure for checking orthostatic vital signs?

• A. Measure after 2 minutes standing only.
• B. Measure blood pressure and pulse after 5 minutes supine, then again after standing, with readings at 1 and 3 minutes.
• C. Measure supine, stand, then sit; take readings at 5 and 10 minutes.
• D. Measure only while seated with no wait time.

Answer: (B)

Orthostatic vital signs involve checking how blood pressure and pulse respond to a change in position, which helps identify an abnormal drop in blood pressure when standing. Start with the patient lying flat for about five minutes to establish a stable baseline for BP and pulse. Then have the patient stand and obtain measurements at about one minute and again at about three minutes after standing. These two postures and time points capture early and delayed changes in the cardiovascular response as venous return adjusts. If the systolic blood pressure falls by roughly 20 mmHg or more, or the diastolic pressure falls by about 10 mmHg within the first three minutes of standing, this indicates orthostatic hypotension; a accompanying increase in pulse supports the finding. Always ensure safety during the transfer and use the same arm with the correct cuff size for consistency. This approach contrasts with procedures that skip the baseline supine measurement, rely only on standing readings, or extend the wait times beyond the typical 3-minute window, all of which can miss the characteristic orthostatic changes.