Certified Hospice and Palliative Assistant (CHPNA) Practice Test

What recommendation is suggested for managing syncopal episodes and falls?

1. Increase fluid intake regardless of blood pressure

2. Consider discontinuing antihypertensive medications

3. Encourage excessive physical activity

4. Modify the patient's diet to include more salt

The correct answer is: Consider discontinuing antihypertensive medications

Discontinuing antihypertensive medications can be a critical recommendation for managing syncopal episodes and falls, particularly in older adults or individuals with varying blood pressure levels. In such cases, medication that lowers blood pressure may contribute to episodes of syncope, especially if the patient experiences orthostatic hypotension (a sudden drop in blood pressure upon standing). By re-evaluating and potentially discontinuing these medications, healthcare providers can help mitigate the risk of falls and fainting spells associated with low blood pressure. This approach supports a more individualized treatment plan tailored to the patient's current health status, which is crucial when addressing concerns such as syncope and fall risk. In contrast, increasing fluid intake or modifying the diet to include more salt might be beneficial in some circumstances, primarily to raise blood volume and blood pressure; however, these strategies do not directly address the root cause if the patient is on antihypertensive therapy. Encouraging excessive physical activity could be detrimental, as it might increase the risk of falls or syncope in vulnerable individuals. Hence, reconsidering the use of antihypertensive medications is a more effective strategy in managing these episodes.