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October 30, 2020
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October 30, 2020
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Substantive additions on Hypertension

Respond to the Subject below following the following topics. By adding substantive addition.
1.First substantive addition: content Demonstrates high level of understanding related to original post. Adds information relevant to nursing practice. Demonstrates critical analysis. Based in evidence (2 points)
2. First substantive addition: Writing mechanics Integrates at least one citation/reference from evidence-based source other than required textbook. Fewer than four writing mechanics errors. Flows clearly and logically. (2 point
3. Second substantive addition: content Demonstrates high level of understanding related to original post. Adds information relevant to nursing practice. Demonstrates critical analysis. Based in evidence (2 points
3. second substantive addition: Writing mechanics Integrates at least one citation/reference from evidence-based source other than required textbook. Fewer than four writing mechanics errors. Flows clearly and logically. (2 point

Pathophysiology helps us understand the ‘whys’, enabling you to better generalize that knowledge to similar situations. This is a big part of critical thinking and clinical judgment! When you truly understand the rationale behind what you see and what you do, light bulb moments occur, and nursing process makes sense!! When you understand the whys, critical thinking expands, and you will able to generalize that knowledge of pathophysiology to a variety of patient scenarios. And when you can do that, patients often experience better outcomes! Not everyone you will care for has a single, or definitive medical diagnosis. Not all individuals with a diagnosis fit the textbook scenario. As nurses we assess individuals with unique signs and symptoms we dont assess a stroke or MI we assess people! There are many signs and symptoms that have a variety of causes. And there are many health alterations that manifest in multiple ways, particularly when there are other comorbidities. This makes it imperative that the nurse is able to think about a whole situation critically and figure out what is going on from a pathophysiologic perspective. For example, when a person presents with tachypnea it could be related to COVID 19, asthma, ARDS, heart failure, anemia, over exertion, fever, neurologic injury, gastric distension, activity intolerance, complications of diabetes, anxiety, acid base imbalance, drug overdose, and more. When a person presents with confusion, it could be related to a stroke, MI, heart failure, cerebral hypoxia, neurologic injury, anxiety, medication change, infection, and more. The nurse must look at the whole situation and think critically to help the patient. All confusion is not the same, all breathing challenges are not the same! And appropriate intervention depends on the through assessment of the specific situation. Understanding the why of your intervention helps you to generalize interventions to similar situations. For example, why did you administer pain medication? In the situation of an MI, why did you administer morphine? To reduce pain; reduce the workload of the heart (and so decrease myocardial oxygen demand); relax smooth muscle (and so decrease BP and reduce cardiac workload); and reduce circulating catecholamines (and so reduce the heart rate and myocardial oxygen demand). Why did you administer acetaminophen when a person has a fever? For comfort, but also to decrease the work of the heart, the work of the lungs, and sometimes to reduce fluid loss and maintain vascular volume. Why is supplemental oxygen helpful when a person experiences activity intolerance? Why doesnt the administration of oxygen help in situations of ARDS?? Often 12 our interventions have cascading type effects. When you understand the whys of assessment findings and interventions, critical thinking expands, and you should be able to generalize that knowledge of pathophysiology to a variety of patient situations. And when you can do that, patients often experience better outcomes!

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