You are caring for a patient in the ICU whose condition is deteriorating. You receive orders for dopamine, which is an intravenous vasoactive drug

Question

What would be your priority assessment and interventions specific to the administration of vasoactive medications?
A) Frequent vitals, monitoring the central line site, and providing accurate drug titration
B) Reviewing medications, performing a focused cardiovascular assessment, and providing patient education
C) Reviewing the laboratory findings, monitoring urine output, and assessing for peripheral edema
D) Routine vitals, monitoring the peripheral IV site, and providing early discharge instructions

Answer 1

Ans: A
Feedback: When vasoactive medications are administered, vital signs must be monitored frequently (at least every 15 minutes until stable, or more often if indicated). Vasoactive medications should be administered through a central venous line because infiltration and extravasation of some vasoactive medications can cause tissue necrosis and sloughing. An intravenous pump should be used to ensure that the medications are delivered safely and accurately. Individual medication dosages are usually titrated by the nurse, who adjusts drip rates based on the prescribed dose and the patient's response. Option B is incorrect; reviewing medications, performing a focused cardiovascular assessment, and providing patient education are important nursing tasks, but they are not specific to the administration of intravenous vasoactive drugs. Option C is incorrect; reviewing the laboratory findings, monitoring urine output, and assessing for peripheral edema are not the priorities for administration of intravenous vasoactive drugs. Option D is incorrect; the vitals are taken on a frequent basis when monitoring administration of intravenous vasoactive drugs, vasoactive medications should be administered through a central venous line, and early discharge instructions would be inappropriate in this time of crisis.