What should the nurse recognize as an indication for the use of dopamine in the care of a patient with heart failure?

• A. Acute anxiety
• B. Hypotension and tachycardia
• C. Peripheral edema and weight gain
• D. Paroxysmal nocturnal dyspnea

Answer: (B)

Dopamine is used in heart failure when there is poor perfusion due to low blood pressure. It has dose-dependent effects that help support the failing heart: it increases contractility (inotropy) and, at higher doses, raises systemic vascular resistance to boost blood pressure. When a patient is hypotensive, the reduced forward flow leads to inadequate organ perfusion, so an inotrope/vasopressor like dopamine can improve cardiac output and renal perfusion. Tachycardia can occur as a consequence of its beta-1 and overall sympathetic effects, but the key reason for use is the low blood pressure with compromised perfusion.

Acute anxiety, edema with weight gain, and nocturnal dyspnea are not indications for dopamine. Anxiety is a psychological symptom, edema and weight gain reflect fluid overload managed with diuretics and other HF therapies, and nocturnal dyspnea signals pulmonary congestion best treated with diuretics, oxygen, and afterload/venodilator strategies.