Pharmacology Vasopressors #5

Question

Which would indicate effectiveness of treatment with dopamine in a client with kidney failure related to decreased renal perfusion due to decreased cardiac output? Select all that apply.

Answers

  1. Increasing creatinine
    • Rationale:

      This answer is not correct because increasing creatinine would reflect increasing kidney failure. Decreased kidney function is associated with decreased creatinine and BUN. This is not the goal of treatment for dopamine.

  2. Increasing blood pressure
    • Rationale:

      This answer is correct because increasing blood pressure is opposite of the symptoms of shock and decreased cardiac output. Dopamine works to increase blood pressure and cardiac output, increasing renal blood flow. Dopamine is commonly used to treat kidney failure caused by low cardiac output.

  3. Increasing urinary output
    • Rationale:

      This answer is correct because increased urinary output reflects increased perfusion of the kidneys. This is the goal of treatment with dopamine during treatment of kidney failure.

  4. Increasing bronchodilation
    • Rationale:

      This answer is not correct because dopamine does not cause increased bronchodilation. Epinephrine causes bronchodilation when given to an asthma client or during an allergic reaction.

  5. Increasing ALT and AST (liver)
    • Rationale:

      This answer is not correct because increasing ALT and AST indicates decreased liver function. The client in the scenario has decreased kidney function, which is reflected in the BUN and creatinine. Increasing ALT and AST is not the goal of treatment of dopamine.

Overview

Dopamine therapy is used when there is low cardiac output, decreasing BP, causing kidney dysfunction and failure. The nurse should monitor the client, assessing signs of effective treatment, including increasing blood pressure and urinary output.

Explanation

Learning Outcomes

Dopamine is prescribed by the healthcare provider when it is determined the client is experiencing decreased cardiac output which can or already has shown signs of kidney failure. Decreased blood pressure will indicate decreased cardiac output, which prevents adequate perfusion to the kidneys. This will result in kidney failure. Therefore, dopamine is administered to help restore adequate cardiac output, blood pressure, and kidney function. Clinical signs indicating the treatment is effective includes increasing blood pressure, which will begin to restore perfusion to the kidneys, resulting in increased urinary output and decreasing creatinine and blood urea nitrogen (BUN) laboratory results.

Test Taking Tip

Understanding pathophysiology will help nursing students think logically through clinical manifestation of the various medical conditions presented in NCLEX-style questions. This understanding will also bring greater understanding in all areas of nursing after passing the NCLEX.

Video Rationale