QUESTION: "Terbutaline (Brethine) therapy is ordered for a client with preterm labor. Before beginning therapy, which of the following assessments would be most important?"
CHOICES
( X ) a.) Contraction intensity.
( X ) b.) Deep tendon reflexes.
( X ) c.) Estimated fetal size.
( O ) d.) Maternal heart rate.
RATIONALE: Terbutaline, a beta-2 selective adrenergic agonist, is used to suppress labor by relaxing the pregnant uterus. In some cases, its beta-2 selectivity is lost, causing cardiac overstimulation. Generally, the drug is contraindicated for a client with a heart rate greater than 130 beats/minute or any cardiac arrhythmias. Therefore, the nurse would need to assess the client's heart rate. The frequency of uterine contractions is an important assessment, but the intensity of the contractions should not be a primary factor in determining if terbutaline therapy is warranted. Estimated size of the fetus should be investigated but fetal size does not contraindicate the use of terbutaline. Terbutaline does not affect deep tendon reflexes. However, magnesium sulfate may depress reflexes. NURSING PROCESS STEP: Assessment CLIENT NEEDS CATEGORY: Physiological integrity CLIENT NEEDS SUBCATEGORY: Pharmacological and parenteral therapies
