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Anesthesia · single question

A well-controlled hypertensive patient becomes lightheaded about 10 minutes into a procedure (no anesthetic given yet). What is the most appropriate immediate step?

  1. Place the patient in a supine position (with legs slightly elevated if tolerated) and monitor vital signs
  2. Immediately administer an aromatic ammonia inhalant without repositioning the patient first
  3. Reassure the patient and continue the procedure without changing position
  4. Tell the patient it is nothing of concern and proceed
Show answer and explanation

Correct answer: A. Place the patient in a supine position (with legs slightly elevated if tolerated) and monitor vital signs

Lightheadedness/presyncope is most often due to a transient drop in cerebral perfusion (orthostatic or vasovagal-type response). The first and safest step is to recline the patient to a supine position to improve venous return and cerebral blood flow, then reassess vital signs before deciding on further steps (which might include an ammonia inhalant for true vasovagal syncope, oxygen, etc., only after repositioning).

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