NOREPINEPHRINE BITARTRATE

(nor-ep-i-nef’rin)
Levarterenol, Levophed, Noradrenaline
Classifications:
autonomic nervous system agent; alpha- and beta-adrenergic agonist (sympathomimetic)
Prototype: Epinephrine
Pregnancy Category: D

NURSING IMPLICATIONS

Assessment & Drug Effects

  • Monitor constantly while patient is receiving norepinephrine. Take baseline BP and pulse before start of therapy, then q2min from initiation of drug until stabilization occurs at desired level, then every 5 min during drug administration.
  • Adjust flow rate to maintain BP at low normal (usually 80–100 mm Hg systolic) in normotensive patients. In previously hypertensive patients, systolic is generally maintained no higher than 40 mm Hg below preexisting systolic level.
  • Observe carefully and record mental status (index of cerebral circulation), skin temperature of extremities, and color (especially of earlobes, lips, nail beds) in addition to vital signs.
  • Monitor I&O. Urinary retention and kidney shutdown are possibilities, especially in hypovolemic patients. Urinary output is a sensitive indicator of the degree of renal perfusion. Report decrease in urinary output or change in I&O ratio.
  • Be alert to patient’s complaints of headache, vomiting, palpitation, arrhythmias, chest pain, photophobia, and blurred vision as possible symptoms of overdosage. Reflex bradycardia may occur as a result of rise in BP.
  • Continue to monitor vital signs and observe patient closely after cessation of therapy for clinical sign of circulatory inadequacy.

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