Following an earthquake, a client who was rescued from a collapsed building is seen in the emergency department. He has blunt trauma to the thorax and abdomen. The nursing observation that most suggests the client is bleeding is:
You selected: a recent history of warfarin (Coumadin) usage.
Incorrect
Correct response: orthostatic hypotension.

orthostatic hypotension

Explanation: Orthostatic hypotension is a sharp drop in blood pressure that occurs when standing up. To diagnose this condition, the systolic blood pressure has to drop by 20mmHg and the diastolic blood pressure by 10 mmHg shortly after a patient gets on their feet.

This condition is caused by the inability of blood pressure to change according to changes in postures. Symptoms include nausea and dizziness.  When this condition is combined with trauma to the torso, it can result in bleeding.