After administering nitroglycerin, a patient experiences dizziness and a 30 mm Hg drop in systolic BP; what is the correct position?

• A. Sit her up and reassess
• B. Place her supine and elevate her legs
• C. Stand her up and monitor
• D. Administer another dose of nitroglycerin

Answer: (B)

Nitroglycerin lowers blood pressure by dilating veins, which reduces venous return (preload). When a patient becomes dizzy with a notable drop in systolic BP after nitro, the priority is to restore perfusion. Placing the patient supine and elevating the legs increases venous return to the heart, raises preload, and helps elevate blood pressure, which can lessen dizziness and prevent further cerebral hypoperfusion. Sitting up or standing would reduce venous return and worsen the hypotension, and giving another nitro dose would likely lower the BP further. After positioning, continue to monitor vitals and provide supportive care per protocol.