A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect?
A.
Systolic blood pressure is increased
B.
Radial heart rate is increased
C.
Cardiac output is reduced
D.
Urine output is reduced
The correct answer and Explanation is :
The correct answer is A. Systolic blood pressure is increased.
Explanation:
Dopamine is a catecholamine that, at various doses, can have different effects on the cardiovascular system. It’s often used in the management of heart failure, especially in acute settings, to improve cardiac output and stabilize blood pressure.
- Systolic Blood Pressure Increased:
- Dopamine, when administered in moderate to high doses, acts on β1-adrenergic receptors in the heart. This action increases heart rate and myocardial contractility, which in turn improves cardiac output and can elevate blood pressure. In the context of left ventricular failure, where the heart struggles to pump effectively, the increase in systolic blood pressure indicates that dopamine is effectively enhancing cardiac performance and output. This is a desirable therapeutic effect, as it reflects improved hemodynamics.
- Radial Heart Rate Increased:
- While an increase in heart rate might be observed with dopamine administration due to its β1-adrenergic effects, this is not necessarily an indicator of therapeutic effectiveness. A higher heart rate can be a result of increased myocardial demand or an adverse response, especially if it’s excessive or accompanied by other symptoms.
- Cardiac Output Reduced:
- A reduction in cardiac output would indicate that the medication is not achieving its therapeutic goal. Dopamine aims to improve cardiac output, not decrease it. A reduced cardiac output would suggest that the medication is not effectively supporting the heart’s pumping function.
- Urine Output Reduced:
- Urine output is often used as a marker of kidney perfusion and overall fluid status. Inadequate urine output may suggest poor perfusion or worsening of heart failure, not an improvement. Dopamine should ideally enhance renal perfusion, leading to improved or stable urine output. A reduction in urine output would be contrary to the expected beneficial effects of dopamine therapy.
In summary, an increased systolic blood pressure is the most direct indicator that dopamine is having a positive therapeutic effect in this scenario, as it signifies improved cardiac function and hemodynamic stability.