A nurse is preparing to administer 1,000 mL of lactated Ringer's IV over 6 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A) Lowered heart rate:
Dopamine typically increases heart rate as it acts on beta-adrenergic receptors in the heart, leading to increased cardiac contractility and chronotropy. However, at low doses, the effect on heart rate may be minimal compared to higher doses.

B) Decreased conduction through the AV node:
Dopamine may have minimal effects on conduction through the atrioventricular (AV) node, especially at low doses. It primarily acts on adrenergic receptors to increase cardiac contractility and heart rate.

C) Increased urine output.
Dopamine is a medication commonly used to treat shock by improving cardiac output and blood pressure. At low doses, dopamine primarily acts on dopamine receptors in the renal blood vessels, causing vasodilation and increased renal blood flow. This increased renal blood flow leads to increased glomerular filtration rate (GFR) and urine output. Therefore, increased urine output is an expected effect of dopamine infusion at low doses in the treatment of shock.

D) Vasoconstriction of renal blood vessels:
At low doses, dopamine primarily acts on dopamine receptors in the renal blood vessels, causing vasodilation and increased renal blood flow. Vasoconstriction of renal blood vessels is more commonly associated with higher doses of dopamine or with other vasopressor medications such as norepinephrine or phenylephrine.

A. Hypotension: Norepinephrine is administered to treat hypotension, so monitoring for hypotension is not typically a concern while the patient is receiving this medication. In fact, hypotension is often the reason for administering norepinephrine in the first place.

B. Liver failure: Monitoring for signs of liver failure may be important in patients receiving certain medications, but it is not a specific consideration when administering norepinephrine. Norepinephrine primarily affects blood pressure regulation and does not typically have direct effects on liver function.

C. Bradycardia: While norepinephrine can increase blood pressure by constricting blood vessels, it may also cause reflex bradycardia (a decrease in heart rate) as a compensatory response. However, the primary concern with norepinephrine administration is hypertension, not bradycardia.

D. Hypertension
Norepinephrine (Levophed) is a vasopressor medication commonly used to treat hypotension and shock. It works by constricting blood vessels, which increases blood pressure. Therefore, when administering norepinephrine, the nurse should monitor the patient for hypertension, as the medication's intended effect is to raise blood pressure.