Included In This Lesson
Study Tools
Outline
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
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
| Nursing Intervention (ADPIE) | Rationale |
| Prevent injury-nonskid socks doesn’t walk without assistance, bed in the 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 the 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 the level of consciousness. | Monitor appropriately and notify MD if needed, promote safety |
| Promote adequate fluid intake | Prevents worsening hypotension |
A Nursing Care Plan (NCP) for Syncope (Fainting) starts when at patient admission and documents all activities and changes in the patient’s condition. The goal of an NCP is to create a treatment plan that is specific to the patient. They should be anchored in evidence-based practices and accurately record existing data and identify potential needs or risks.
References
https://my.clevelandclinic.org/health/diseases/17536-syncope
https://www.heart.org/en/health-topics/arrhythmia/symptoms-diagnosis–monitoring-of-arrhythmia/syncope-fainting
https://medlineplus.gov/fainting.html
Transcript
Hey everyone. Today, we are going to be creating a nursing care plan for syncope, or fainting. So let’s get started. First, we’re going to go over the pathophysiology. So, syncope is essentially loss of consciousness, which is typically caused by hypertension. The brain lacks adequate blood flow, causing temporary loss of consciousness. Some nursing considerations. We want to prevent injury, slow position changes, reevaluating medications, any changes in LOS. We want to promote fluid intake. Some desired outcomes. We want no additional syncope events, no injury, identification of cause and treatment to prevent that further episode.
So we’re going to go ahead and get into the care plan. We’re going to be writing some subjective data and we’re going to be writing out some objective data. So what are we going to see in this patient? So we’re going to see that they’re going to complain of some nausea and possible blurred vision. They’ll also be hypotensive and bradycardic. Other things, they are probably going to be feeling a little cold, clammy, possibly warm,and experience some blurred vision, vomiting, loss of consciousness, possible arrhythmias, and confusion. Disorientation is a big one.
So interventions that we want to do: we want to make sure that we are preventing injury, Sudden loss of consciousness puts patients at a higher risk for falls. So you want to make sure your patient has non-skid socks, making sure that they’re not walking around without assistance. The beds in the lower locked position necessary items are within reach for the patient. Make sure the call lights are within reach for the patient and the side rails are up. We want to educate the patient to change positions slowly. This enables blood pressure to accommodate those position changes and hopefully prevents future episodes. Another invention we’re going to be doing is reevaluating their medications. So, which medications are they on that could be causing them to be pretty hypertensive; in particular, blood pressure medications may need to be spaced out or the doses may need to be adjusted. So these are things to discuss with the physician. Now an intervention we’re going to be doing is monitoring for changes in their level of consciousness, monitor appropriately for any changes and make sure you’re notifying the physician if there are any changes in the patient. We always want to make sure we’re promoting safety. Now, an intervention we’re going to be doing is to promote adequate fluid intake. So by increasing fluids, we want to prevent any worsening hypotension. Another intervention we’re going to be doing is education. Always want to make sure we’re educating the patient on their treatment plan and any protocols or interventions that we’re putting in place.
Okay, we’re going to go over the key points here. So syncope is essentially loss of consciousness, which is caused by hypertension. The brain’s lacking adequate blood flow causing temporary loss of consciousness. Some subjective objective data. They’re going to have nausea, feel cold, clammy, warm, tunnel vision, or blurred vision, loss of consciousness, hypotension, bradycardic, and confusion. We want to make sure we’re preventing injury, educating the patient on the slow positioning changes. So if they’re going from laying down to sitting up, make sure they’re doing that slowly or from sitting position to standing. We want to reevaluate their medications and monitor for changes in their level of consciousness and encourage fluid intake to prevent any further hypotension. And there you have that care plan.
Awesome. We love you guys. Go out, be your best self today and as always happy nursing.
Miriam Wahrman, MSN/Ed, RNC-MNN 
Nichole Weaver, MSN/Ed, RN, CCRN 
