The nurse is caring for a patient in hypovolemic shock on a norepinephrine infusion. Which assessment finding indicates that the medication is therapeutic?

A. Urinary output increases to 45 ml/hr: Norepinephrine is a potent vasoconstrictor that increases systemic vascular resistance and blood pressure, improving perfusion to vital organs. An increase in urinary output reflects improved renal perfusion and glomerular filtration, indicating that the medication is effectively restoring circulatory volume and supporting end-organ function. B. Blood pressure changes from 68/40 mmHg to 67/42 mmHg: Minimal change in blood pressure suggests that the norepinephrine infusion is not yet producing a therapeutic effect. Persistent hypotension indicates ongoing inadequate perfusion, requiring reassessment of dosage, fluid status, or additional interventions. C. The mean arterial pressure decreases to 60 mmHg: A declining mean arterial pressure reflects worsening perfusion and inadequate response to therapy. Since norepinephrine is intended to raise MAP to maintain tissue perfusion (typically ≥65 mmHg), a decrease signals that the infusion is not achieving its hemodynamic goal. D. Sinus rhythm on the cardiac monitor: Maintaining sinus rhythm is important, but it does not directly indicate the effectiveness of norepinephrine in treating hypovolemic shock. The drug’s primary goal is to restore perfusion pressure and organ perfusion, not to correct heart rhythm.