Info

Medication or Drug Class

Dosage

Description

Rationale

Sympathomimetics such as dopamine hydrocholoride

Varies by drug

Stimulates adrenergic receptors to increase myocardial contractility and peripheral resistance

Supports blood pressure and cardiac output in emergencies until bleeding is brought under control; only used if fluid resuscitation is initiated

Note: Diuretics, nitrates, or other preload-reducing agents are absolutely contraindicated in cardiac tamponade.

Note: Diuretics, nitrates, or other preload-reducing agents are absolutely contraindicated in cardiac tamponade.

Independent

The highest nursing priority is to maintain the patient's ABCs. Emergency equipment should be readily available, should the patient require intubation and mechanical ventilation. Be prepared to administer fluids, including blood products, colloids or crystalloids, and pressor agents, through a large-bore catheter. Pressure and rapid-volume warmer infusors should be used for patients who require massive fluid resuscitation. A number of nursing strategies increase the rate of fluid replacement. Fluid resuscitation is most efficient through a short, large-bore peripheral intravenous (IV) catheter in a large peripheral vein. The IV should have a short length of tubing from the bag or bottle to the IV site. If pressure is applied to the bag, fluid resuscitation occurs more rapidly.

Emotional support of the patient and family is also a key nursing intervention. If the patient is awake as you implement strategies to manage the ABCs, provide a running explanation of the procedures. If blood component therapy is essential, answer the patient's and family's questions about the risks of hepatitis and transmission of the human immunodeficiency virus (HIV).

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