What are signs a resident cannot tolerate a transfer (orthostatic intolerance)?

• A. Hunger and thirst
• B. High blood pressure and sweating
• C. Dizziness only
• D. Dizziness, pallor, sweating, fainting; stop transfer and assist back to bed

Answer: (D)

Orthostatic intolerance occurs when moving a resident to an upright position causes inadequate blood flow to the brain. The signs to watch for are dizziness or lightheadedness, pallor (pale skin), sweating, and sometimes fainting. When these symptoms appear during a transfer, continuing the move can lead to a fall or injury, so the safest action is to stop the transfer, lower the resident back to bed, and assist them to lie down. If trained, check vitals and monitor for any worsening symptoms, and seek help as needed. Hunger and thirst aren’t indicators of orthostatic intolerance, and high blood pressure with sweating isn’t the typical pattern seen with this condition; dizziness alone may occur for other reasons, but the combination of dizziness with pallor, sweating, and possible fainting most strongly signals orthostatic intolerance.