Assessment

• Monitor blood pressure every 2–3 min until stabilized and every 5 min thereafter. Systolic blood pressure is usually maintained at 80–100 mm Hg or 30–40 mm Hg below the previously existing systolic pressure in previously hypertensive patients. Consult physician for parameters. Continue to monitor blood pressure frequently for hypotension following discontinuation of norepinephrine

• ECG should be monitored continuously. CVP, intra-arterial pressure, pulmonary artery diastolic pressure, pulmonary capillary wedge pressure (PCWP), and cardiac output may also be monitored

• Monitor urine output and notify health care professional if it decreases to <30 mL/hr

• Assess IV site frequently throughout infusion. A large vein should be used to minimize risk of extravasation, which may cause tissue necrosis. Phentolamine 5–10 mg may be added to each liter of solution to prevent sloughing of tissue in extravasation. If extravasation occurs, the site should be infiltrated promptly with 10–15 mL of 0.9% NaCl solution containing 5–10 mg of phentolamine to prevent necrosis and sloughing. If prolonged therapy is required or if blanching along the course of the vein occurs, change injection sites to provide relief from vasoconstriction

• If overdose occurs, discontinue norepinephrine and administer fluid and electrolyte replacement therapy. An alpha-adrenergic blocking agent (phentolamine 5–10 mg) may be administered intravenously to treat hypertension

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