When administering dopamine (Intropin), it is most important for the nurse to know that:
A. The drug’s action varies according to the dose.
B. The drug may be used instead of fluid replacement.
C. The drug cannot be directly mixed in solutions containing bicarbonate or aminophylline.
D. The lowest dose to produce the desired effect should be used.
Correct Answer: C. The drug cannot be directly mixed in solutions containing bicarbonate or aminophylline.
The nurse is responsible for knowing compatible solutions before administering dopamine (Intropin). In patients with conditions of the heart or circulatory system, the intravenous administration of dopamine is contraindicated. These conditions may include ventricular arrhythmias and tachycardia, blood vessel blockage, low blood-oxygen content, decreased blood volume, acidosis, and adrenal gland dysfunctions resulting in high blood pressure such as pheochromocytoma.
Option A: It is important to know that drug action varies by dose, but the physician is responsible for determining the dose. For stimulation of the sympathetic nervous system, the indication is for a continuous intravenous drip administration. Dopamine half-life in the systemic circulation is between 1 to 5 minutes; thus, slower forms of administration, such as oral administration, are typically ineffective.
Option B: Dopamine should not be used instead of fluid replacement. Indications for DA include maintenance of blood pressure for chronic congestive heart failure, trauma, renal failure, and even open-heart surgery and shock from myocardial infarction or septicemia. DA administration in low doses may also be beneficial to manage hypotension, low cardiac output, and inadequate organ perfusion (often indicated by low urine production).
Option D: Although it is true, it is not the nurse’s primary concern. It is a collaborative action in which the physician is involved in determining the rate. Low infusion rates (0.5 to 2 micrograms/kg per minute) act on the visceral vasculature to produce vasodilation, including the kidneys, resulting in increased urinary flow.