A patient with multiple organ dysfunction syndrome is receiving dopamine at a rate of 20 mcg/kg/min. Which of the following actions would the nurse expect the patient to demonstrate?
1. increase in cardiac output
2. increase in urine output
3. increase in peripheral pulses
4. increase in blood pressure
4
Rationale: An increase in blood pressure is correct. Dopamine in doses greater than 10 mc/kg/min stimulates alpha–adrenergic receptors causing increased peripheral vascular resistance and renal vasoconstriction. These actions cause increased blood pressure, cold mottled extremities, and decreased urine output. Increase in cardiac output is incorrect because it occurs with dopamine at moderate doses when beta–adrenergic receptors produce cardiac stimulation. Heart rates can increase as a side effect of dopamine but not necessarily increase the cardiac output. Increase in urine output is incorrect because it occurs when dopamine is administered in low doses and dopaminergic effects occur, thus vasodilating the renal arteries. Increase in peripheral pulses is incorrect because it will occur if cardiac output is sufficient and peripheral vascular vasoconstriction is adequate to palpate pulses and not overly constrict, such as in high dopamine doses.
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