How to take orthostatic vital signs
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
Orthostatic vital signs find low blood pressure on standing, a common cause of dizziness and falls.
Step by step
Prepare
Explain, have help nearby, patient lying for at least 5 minutes. [1]
Lying
Blood pressure and pulse. [1]
Stand
Help the patient stand (or sit if they cannot stand). Stay close. [1]
Measure standing
Blood pressure and pulse at 1 and 3 minutes. [2]
Positive result
Systolic drop of 20 mmHg or more, or diastolic drop of 10 or more, within 3 minutes, or symptoms. [2]
Safety
Stop and lay the patient down if they feel faint. [1]
Record
All values with positions and times, and symptoms. [1]
Common errors
- Not waiting 5 minutes lying down.
- Leaving the patient alone standing.
- Not recording symptoms.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Parkinson disease, home safety
- Hypoglycemia at school
- Tuberculosis, contact with symptoms
- ADHD with weight loss
- Ectopic pregnancy
- Postpartum hemorrhage
102 Making Synapses cases train this skill: open the case library
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- CDC STEADI (falls in older adults)
- OpenStax, Clinical Nursing Skills (reference)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow OpenStax, Clinical Nursing Skills (reference). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.