Pathophysiology
Syncope is essentially a loss of consciousness, which is typically caused by hypotension. The brain lacks adequate blood flow and a temporary loss of consciousness results.
Etiology
Syncope typically has a cardiac etiology, but can also be due to many other things (like a side effect from a med, neuro issue, psych issue, or lung problem). When a cardiac etiology is suspected, a cardiac workup is completed. This typically includes cardiac monitoring, labs, and routine vital signs (specifically blood pressure and heart rate).
Desired Outcome
No additional syncopal events, no injury, identification of cause and treatment to prevent further episodes
Syncope Nursing Care Plan
Subjective Data:
- Nausea
- Feeling cold, clammy, or warm
- Tunnel vision
- Blurred vision
Objective Data:
- Vomiting
- Loss of consciousness
- Arrhythmias
- Hypotension
- Pallor
- Bradycardia
- Confusion/disorientation
Nursing Interventions and Rationales
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Prevent injury (nonskid socks, doesn’t walk without assistance, bed in lowest locked position, necessary items within reach, call bell within reach, side rails up x3)
- Sudden loss of consciousness puts patients at a higher risk for falls and injury, therefore it would be prudent to be with the patient when OOB
-
Educate patient to change positions slowly
- This enables the blood pressure to accommodate to position changes and hopefully prevent future episodes
-
Reevaluate medications, review any that may cause syncope with MD
- BP meds may need to be spaced out, or dosages may need to be adjusted; discuss
-
Monitor for changes in level of consciousness.
- Monitor appropriately and notify MD if needed, promote safety
-
Promote adequate fluid intake
- Prevents worsening hypotension
References
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nursing.com/cornell
