Nursing Diagnosis & Care Plan for Syncope- Student’s Guide
Introduction
Syncope is the medical term for fainting. It is a sudden loss of consciousness and muscle tone due to a temporary insufficient supply of blood flow to the brain. The condition may be caused by various conditions, including low blood pressure, dehydration, or standing up too quickly from sitting or lying down.
Nurses are responsible for assessing syncope to provide appropriate care and treatment when needed. In this blog post, we will go over nursing diagnoses related to syncope and caring for individuals with these diagnoses, as a way of educating you as a nursing student.
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Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students, for learning purposes only, and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.
Definition of Syncope
The word syncope is derived from the Greek term meaning “to cut short” or “cut off.” In medical terminology, it refers to a temporary loss of consciousness caused by a lack of blood flow to the brain.
Causes of Syncope
Syncope fainting can be caused by many things, including dehydration, low blood sugar levels, and stress. Physicians need to take note of synopsis symptoms to rule out more serious causes such as aneurysms and cardiac arrest.
Risk Factors for Syncope
The risk factors are the same as the underlying causes. For example, stress may be a major risk factor of syncope. However, if the synapses causing syncope are related to low blood pressure or dehydration, it is also a major risk factor for those conditions.
Types of Syncope
There are two types, vasovagal and neurocardiogenic.
Vasovagal
Vasovagal syncope is caused by the vagus nerve signalling to the heart to slow down or stop beating, which results in a drop in blood pressure causing one to faint.
Neurocardiogenic
Neurocardiogenic syncope is when the brain misinterprets and overreacts to signals of low blood pressure and perceives an internal conflict.
Signs and Symptoms
There are also different symptoms depending on the cause of syncope.
Signs Associated with Vasovagal Syncope
They include;
- Cold, clammy skin
- Body fluids pooling in legs
- Dry mouth
- Sweating Feeling of nausea
- Pale skin
- A sensation of pins and needles in arms, hands, feet, or legs
- Weakness “Racing” heartbeat
- Vision Disturbances
- Feeling of choking
- Chest pain/pressure
Signs Associated with Neurocardiogenic Syncope
- Severe lightheadedness
- Dizziness mainly seen in children and adolescents
- Feeling as if the room is spinning
- Nausea/vomiting
- Pupils may become dilated or remain constricted at times
Nurses need to be able to identify the signs and symptoms of syncope to provide appropriate care.
Medical Diagnosis of Syncope
-Physicians diagnose syncope through extensive physical exams and obtaining a patient history.
-A physical exam may consist of taking blood pressures, checking for bradycardia or tachycardia, and listening to the heart sounds to check for anomalies.
-In addition, a physician will also ask questions about what might have caused the syncope as well when it occurs and how often it does occur.
Common Syncope Nursing Diagnosis
The most common nursing diagnosis associated include;
- Injury Prevention (IP)
- Acute Pain (AP),
- Urinary Incontinence (UI)
- Change in Mental Status (CMS).
Possible Nursing Diagnoses Associated with Syncope
The following is a list of possible diagnoses that may be given to patients who have this condition;
- Activity intolerance
- Anxiety/fear-related behaviors that may include panic attack with a syncopal episode (PAS)
- Blurred vision
- Dizziness/lightheadedness
- Imbalanced nutrition: less than body requirements
- Impaired gas exchange related to ventilation/perfusion imbalance;
- Deficient fluid volume related to inadequate intake or excessive losses;
- Neurogenic bladder due to interruption in the spinal reflex arc;
- Anxiety/fear-related behaviors that may include panic attack with a syncopal episode (PAS);
- Decreased cerebral perfusion resulting from anxiety reactions (CAN)
- Constipation (IC) that may include anorexia, nausea, or vomiting (ANV);
- Nausea and Vomiting related to anxiety;
- Constipation resulting from immobility which may cause decreased activity tolerance (IAT).
It is important to remember that some people may not have any nursing diagnoses. It is also very important for nurses to develop care plans based on individual needs. For this reason, it will be important to perform a full assessment of the patient and formulate an appropriate plan of care in collaboration with the physician treating the patient.
NANDA-I Nursing Diagnoses:
-Inappropriate secretion of antidiuretic hormone linked to autonomic dysregulation in diabetes mellitus
-Noncompliance with therapeutic regimen due to patient education needs, including information on drug/treatment and self-management planning in diabetes mellitus Type II complicated by hyperglycemia (Noncompliance may be the result of patient education needs.)
-Complicated disuse syndrome linked to immobility in complex regional pain syndrome Type II (CRPS)
-Noncompliance with therapeutic regimen as a result of cognitive dysfunction or impaired decision making in mental health disorders due to another general medical condition
-Psychological factors affecting medical conditions, including social isolation and depression due to chronic pain.
Subjective Signs
Anxiety-related to fear of having a stroke or heart attack
Nursing Care Plan for Syncope
-Prevent dehydration and hypoglycemia.
-Teach the client to avoid certain drugs, foods, and activities to lower the risk of syncope from them.
-Educate the clients on safe activity levels for work.
-Educate them about medications that may cause syncope and alternative medications to take in an emergency but do not give exact dosages, as it is increasingly necessary to avoid over-medicating those with low blood pressure or any risk of fainting.
-Teach the family/friend(s) about what to do to help prevent syncope and how long each type can last.
-Discuss with the individuals ways to avoid activities and situations that might trigger the onset of an episode of syncope.
-Teach coping techniques such as relaxation or imagery to the client.
-Discuss with the follow-up clinician how often follow-up is needed for any problems that may arise from this plan of care.
–Risk of Injury/Death (especially if elderly or have other health problems)
-Risk of Hypoglycemia (if the patient has diabetes)
-The person may experience a reduction in blood pressure. Believe that this is normal and should not be alarmed by it. Maintain an open line of communication with the patient’s physician and family.
-Encourage the client to stay in control by repeating back steps or keeping the telephone number of the emergency contact and hospital near the bed for use in an emergency.
Nursing Interventions for Patients with Syncope
General Nursing Interventions:
-Position the client so that they are sitting upright in a chair with legs uncrossed and supported.
-Encourage small, frequent meals to prevent hypoglycemia/dehydration.
-Teach the client about possible signs of syncope (e.g., dizziness and fainting) to recognize when they occur. Teaching them about common causes of syncope can help to decrease the risk of a future episode occurring.
-Teach them relaxation techniques that may be useful during an episode of hypotension, such as guided imagery or deep breathing.
Cognitive Interventions:
-Teach the patient about various types of syncope and how long each type can last. This may help to decrease anxiety related to syncope.
Encourage the patient
-To take a more active role in what happens during an episode of hypotension.
– Talking through an attack causes them to feel like they are choking.
-To imagine what they would want to be done if an episode of hypotension were occurring. Doing this may help them to feel more in control during a future attack.
-Discuss with the patient the importance of avoiding activities and situations that might trigger syncope.
Nursing Intervention for patients with heart problems/cardiovascular disease:
Monitor:
-Vital signs, especially blood pressure and pulse.
-For cardiovascular signs such as chest pain, palpitations, or irregular heartbeat.
-Respiratory problems (dyspnea) that may indicate congestive heart failure is present.
-Assess for signs of fluid and electrolyte imbalance such as thirst, dry mucus membranes (dry mouth), decreased urinary output, weight gain, and edema.
-Compare right upper quadrant abdominal girth measurements with left upper quadrant abdominal girth measurements.
-Monitor for changes in the level of consciousness or behavior patterns that are indicative of the patient’s reaction to pain or other discomforts.
-Observe for changes in skin color that may indicate loss of peripheral circulation (e.g., pale, mottled, cool, clammy)
-Inform the patient about various treatments for cardiovascular problems.
-Teach them relaxation techniques that may be useful during an episode of hypotension, such as guided imagery or deep breathing.
-Discuss with the physician what types of physical activity are recommended and which ones should be avoided by patients with heart problems/cardiovascular disease.
-Discuss with the physician what types of blood pressure medications are best for patients.
Nursing Interventions for Patients who have Sensitivity to Light and/or Noise
-Monitor the patient’s sensitivity to light and noise daily. This may help to detect any patterns or triggers for the episodes of syncope that occur because of these responses.
-Teach clients about various types of syncope and how long each type can last. This may help decrease anxiety related to syncope.
-Encourage talking through a possible attack causing them to feel like they are choking.
-Encourage the client to imagine what they would want to be done if an episode of syncope were occurring. Doing this may help him, or her feel more in control during a future attack.
-Discuss with the client the importance of avoiding activities and situations that might trigger syncope.
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Summary
Syncope is a sudden loss of consciousness and muscle tone. This may be due to decreased blood flow to the brain or an abnormality in heart function, but it can also be due to other causes such as emotional stress. The nurse should assess the patient for risk factors associated with this diagnosis by asking if they have any past medical history, current medications, allergies, and family history.
The nurse should then complete a nursing care plan based on the diagnosis. It should include monitoring vital signs such as pulse rate and BP along with assessing the level of consciousness (LUC), skin coloration, and response time from when they are aroused back into consciousness (RESPONSE TIME). They should also check for injuries related to syncope.
