Hypotension

Area of Science:

• Cardiovascular Medicine
• Clinical Nursing
• Diagnostic Reasoning

Background:

• Advanced practice nurses manage acute onset hypotension.
• Hypotension diagnosis involves diverse pathophysiologic processes (VINDICATE acronym).
• In-hospital adult hypotension commonly stems from vascular (and cardiac) issues like hypovolemia and pump failure.

Purpose of the Study:

• To outline a systematic approach for advanced practice nurses in diagnosing acute onset hypotension.
• To differentiate common causes of hypotension in hospitalized adults.
• To emphasize the integration of diagnostic processes with immediate treatment needs.

Main Methods:

• Utilizing the VINDICATE mnemonic for broad differential diagnosis.
• Applying a stepwise clinical decision-making process.
• Integrating subjective and objective patient data with pattern recognition.

Main Results:

• Identified vascular (and cardiac) processes (absolute hypovolemia, relative hypovolemia, pump failure) as primary causes of adult hospital hypotension.
• Highlighted the necessity of a structured diagnostic approach.
• Emphasized that treatment may precede or occur concurrently with diagnosis.

Conclusions:

• A systematic, evidence-based approach is crucial for advanced practice nurses managing acute hypotension.
• Prioritizing vascular causes simplifies the initial differential diagnosis in hospitalized adults.
• Clinical decision-making must balance diagnostic exploration with timely therapeutic intervention.