Advanced practice nurses are responsible for diagnosing and treating patients with acute onset hypotension. The potential diagnostic hypotheses for hypotension are related to a wide variety of pathophysiologic processes. These processes are represented by the acronym VINDICATE—Vascular (and cardiac), Inflammatory, Neoplastic; Degenerative, Intoxication/latrogenic, Congenital, Allergic/Autoimmune Traumatic, Endocrine/Metabolic However, acute onset hypotension experienced by the adult patient in the hospital is likely to be caused by the vascular (and cardiac) processes of absolute hypovolemia, relative hypovolemia, and pump failure. Developing the differerntial diagnosis for acute onset hypotension involves making a series of clinical decisions in a stepwise manner. The clinician bases these decisions on information contained in a subjective and objective database and on recognizing patterns in the central findings. However, treatment of hypotension may be necessary before or during the diagnostic process, depending on the severity of the patient’s symptoms
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Diagnostic Approach to Common Medical Problems in the Hospitalized Adult| August 01 1997
Marilyn Hravnak, RN, MSN, ACNP-CS, CCRN;
*From the University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania.
†From the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Reprint requests to Marilyn Hravnak RN, MSN, ACNP-CS, CCRN, Acute/Tertiary Care Department, 314 Victoria Building, University of Pittsburgh, Pittsburgh, PA 15261.
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AACN Adv Crit Care (1997) 8 (3): 303–318.
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Marilyn Hravnak, Arthur Boujoukos; Hypotension. AACN Adv Crit Care 1 August 1997; 8 (3): 303–318. doi:
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