A client on bedrest has a prescription to progress activity as tolerated. What is an appropriate initial action?

• A. Advise the client to sit on the edge of the bed for a few minutes before standing again
• B. Stand the patient immediately after waking
• C. Request a physician order to walk the length of hallway
• D. Remain in bed for the rest of shift

Answer: (A)

Gradual progression with safety in mind is the key idea. After bedrest, the body can react to standing with dizziness or a drop in blood pressure, so the safest first step is to have the client sit up on the edge of the bed for a few minutes before standing again. This pause allows venous return to improve, gives the cardiovascular system a moment to adjust, and lets you assess the patient’s tolerance to upright activity. If the patient tolerates this well, you can advance to standing and then to walking as ordered, but you start with this small, controlled change to prevent lightheadedness and falls.

Standing immediately after waking can provoke abrupt orthostatic changes, increasing the risk of dizziness. Walking the hallway typically requires a plan and possibly additional orders, and remaining in bed for the entire shift misses the goal of safely increasing activity.