What is the first nursing action for a hemodialysis patient returning dizzy with a blood pressure of 86/54 mmHg?

• A. Call for help and place in high-Fowler's
• B. Administer IV fluids
• C. Dangle legs
• D. Place supine and assess for hypovolemia

Answer: (D)

When a hemodialysis patient becomes dizzy with severe hypotension, the immediate priority is to protect perfusion and safety. Placing the patient supine helps maximize venous return to the heart, which improves cerebral and overall organ perfusion quickly. Once the patient is flat, you assess for hypovolemia as a likely cause because dialysis removes fluid and can drop intravascular volume. Understanding whether hypovolemia is contributing guides the next steps—such as adjusting the ultrafiltration rate or giving fluids if appropriate—without delaying a safe, perfusion-optimizing position. Treatments like elevating the head or dangling the legs could worsen the low blood pressure, and acting without assessing volume status risks inappropriate management.