Question

a nurse is caring for a client who has heart failure and is receiving an iv infusion of dopamine. which of the following findings indicates that the medication is effective?

decreased blood pressure
increased heart rate
increased cardiac output
decreased serum potassium

Explanation:

Analyze the therapeutic goal of dopamine in heart failure

Using the Dopamine Pharmacology and Heart Failure Management knowledge points

• Dopamine is an intravenous inotropic agent used to treat acute heart failure by stimulating beta-1 adrenergic receptors to increase myocardial contractility.
• The primary therapeutic goal of administering dopamine in a client with heart failure is to improve cardiac contractility and stroke volume, thereby increasing overall cardiac output.
• Increased cardiac output leads to improved systemic tissue perfusion, which is the key indicator of the medication's effectiveness.

Evaluate the clinical findings

Using the Dopamine Pharmacology and Heart Failure Management knowledge points

• Decreased blood pressure: Dopamine typically increases or maintains blood pressure via increased cardiac output and, at higher doses, alpha-1 mediated vasoconstriction. A decrease in blood pressure would indicate worsening shock or lack of efficacy.
• Increased heart rate: While dopamine can cause tachycardia as an adverse effect due to beta-1 stimulation, a significant increase in heart rate is not the desired therapeutic outcome and can increase myocardial oxygen demand.
• Increased cardiac output: This is the direct, desired therapeutic effect of dopamine's positive inotropic action, indicating successful management of heart failure.
• Decreased serum potassium: Hypokalemia is not a therapeutic indicator of dopamine efficacy; rather, dopamine can increase renal perfusion and urine output, but direct serum potassium reduction is not the clinical marker of its effectiveness.

Answer:

• Decreased blood pressure
• (B) Increased heart rate
• Increased cardiac output (Correct answer)
• Decreased serum potassium