A low-dose dopamine infusion is to be started for a client diagnosed with hypovolemic shock. Which assessment finding indicates the drug is having the desired therapeutic effect?
1. Nausea
2. Increased urine output
3. Increased blood pressure
4. Ventricular tachycardia
Correct Answer: 2
Rationale 1: Nausea is a common side effect, not a desired therapeutic effect.
Rationale 2: At low doses, dopamine selectively stimulates dopaminergic receptors, especially in the kidneys, causing increased urine output. At higher doses, dopamine stimulates beta-1 adrenergic receptors, causing the heart to beat more forcefully, thus increasing cardiac output. Also, at higher doses, dopamine stimulates alpha-1 adrenergic receptors, causing vasoconstriction and increased blood pressure.
Rationale 3: Increased blood pressure is not seen with a low-dose dopamine infusion.
Rationale 4: Ventricular tachycardia is not seen with a low-dose dopamine infusion.
Global Rationale: At low doses, dopamine selectively stimulates dopaminergic receptors, especially in the kidneys, causing increased urine output. At higher doses, dopamine stimulates beta-1 adrenergic receptors, causing the heart to beat more forcefully, thus increasing cardiac output. Also, at higher doses, dopamine stimulates alpha-1 adrenergic receptors, causing vasoconstriction and increased blood pressure. Nausea is a common side effect, not a desired therapeutic effect. Increased blood pressure and ventricular tachycardia are not seen with a low-dose dopamine infusion.
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