Nursing Process Focus:
Patients Receiving Norepinephrine (Levarterenol)
Assessment
Potential Nursing Diagnoses
Prior to administration:
 Tissue Perfusion, Ineffective related
to adverse effects of medication
 Obtain complete medical history
including allergies, drug history, and
 Injury, Risk for to tissue related to
possible drug interactions
extravasation of medication
 Assess for history of cardiovascular
 Gas exchange, Impaired related to
disease, obtain EKG
inadequate cardiac output
 Assess blood pressure and pulse, urine
 Knowledge Deficient, related to
output
drug action and side effects
 Obtain medication history for use of
MAOI or tricyclic antidepressants
Planning: Patient Goals and Expected Outcomes
The patient will:
 Demonstrate understanding of risks and benefits of drug therapy
 Maintain adequate tissue perfusion
 Maintain adequate ventilation
Implementation


Interventions and (Rationales)
Monitor for vasoconstrictive effects of
medication including vital signs, mental
status, skin temperature of extremities,
and color of ear lobes, nailbeds, and
lips.
Patient Education/Discharge Planning
Advise patient:
 Concerning need for continuous
monitoring
 That continuous heart monitoring will
occur while medication is infusing
 To immediately report any chest pain,
palpitations or blurred vision
 Advise patient to immediately report
any burning at the IV site.
Maintain integrity of I.V. infusion.
(Infusion should be started only after
patency of IV is assured. Monitor flow
rate of medication infusion
continuously. Be alert for any signs of
extravasation.)
Explain to patient the:
 Monitor renal status, including urine
output (usually will have foley catheter),
 Need for frequent monitoring and
BUN and creatinine lab values. (Severe
 Rationale for Foley catheter
vasoconstriction can reduce renal
perfusion.)
Evaluation of Outcome Criteria
Evaluate the effectiveness of drug therapy by confirming that patient goals and expected
outcomes have been met (see “Planning”).
Nursing Process Focus:
Patients Receiving Dopamine (Dopastat)
Assessment
Potential Nursing Diagnoses
Prior to administration:
 Tissue perfusion, Risk for Ineffective
related to poor cardiac output
 Obtain complete health history
including allergies, drug history and
 Gas exchange, Risk for Impaired related
possible drug interactions
to inadequate pulmonary blood flow
 Assess for history of cardiovascular
 Injury, Risk for (tissue) related to
disease, obtain EKG
necrosis of local tissue from
 Assess blood pressure and pulse, urine
extravasation of medication
output
 Knowledge Deficient, related to drug
action and side effects
 Assess patient’s weight
Planning: Patient Goals and Expected Outcomes
The patient will:
 Demonstrate understanding of risks and benefits of medication therapy
 Maintain adequate tissue perfusion
 Avoid injury to tissues
 Maintain adequate ventilation
Implementation


Interventions and (Rationales)
Monitor vital signs and tissue integrity
frequently. (Vasoconstrictive effects of
drug can result in tissue necrosis.)
Patient Education/Discharge Planning
Advise patient:
 That continuous cardiac monitoring will
occur while patient is receiving
medication
 To immediately report any numbness or
tingling in the extremities, or chest pain
 Inform patient of frequent monitoring
and rationale for Foley catheter.
Monitor renal status, including urine
output (usually will have foley
catheter), BUN and creatinine lab
values.
 Ensure patency of IV prior to
 Instruct patient to immediately report
beginning infusion and monitor site
any burning at the IV site.
frequently. (Extravasation of
medication into tissues may result in
sloughing of tissue or gangrene.)
Evaluation of Outcome Criteria
Evaluate the effectiveness of drug therapy by confirming that patient goals and expected
outcomes have been met (see “Planning”).