A nurse is caring for a client with cardiomyopathy and is receiving a dobutamine drip. Which assessment finding indicates that the medication is effectively working?

A. Increased respiratory rate: An increased respiratory rate may indicate persistent heart failure, hypoxia, or worsening pulmonary congestion rather than improvement. Dobutamine is intended to enhance myocardial contractility and improve cardiac output, which should reduce compensatory tachypnea associated with poor perfusion. B. Decreased blood pressure: Dobutamine is a beta-1 adrenergic agonist that increases myocardial contractility and stroke volume, typically improving cardiac output and supporting blood pressure. A decrease in blood pressure may indicate worsening cardiac function or excessive vasodilation, not effective therapy. C. Increased urine output: Improved cardiac output enhances renal perfusion, leading to increased glomerular filtration rate and urine production. In clients with cardiomyopathy, low urine output often reflects poor forward flow. An increase in urine output suggests improved tissue perfusion and effective inotropic support. D. Decreased blood glucose: Dobutamine does not directly lower blood glucose levels. Its primary action is to stimulate beta-1 receptors in the heart to increase contractility and cardiac output. Blood glucose changes are not used as indicators of therapeutic effectiveness for this medication.