A male client with venous incompetence stands up and his blood pressure subsequently drops. Which physiologic response is most likely?

• A. Decrease in pulse rate
• B. Fever
• C. Increase in pulse rate
• D. No change in vital signs

Answer: (C)

When standing with venous incompetence, gravity causes more blood to pool in the legs, reducing venous return to the heart. This lowers stroke volume and can drop blood pressure. The body uses the baroreceptor reflex to compensate: sensors in the carotid arteries and aorta detect the fall in pressure and trigger sympathetic activation, which increases heart rate (and can cause vasoconstriction) to restore cardiac output and stabilize blood pressure. The most likely response is an increase in pulse rate. Fever or no change in vital signs wouldn’t explain the acute drop, and a decrease in pulse rate would not help counteract the fall in blood pressure.