A nurse is administering terbutaline to a client who is at 31 weeks of gestation and has pre-term labor.

Which of the following findings should the nurse monitor as an adverse effect of this medication?

Hypotension

Tachycardia

Hyperglycemia

Hypokalemia

Answer and Explanation

The Correct Answer is B

Tachycardia.

Terbutaline is a medication that can be used to stop or delay preterm labor by relaxing the uterine muscles. However, it can also cause serious side effects for both the mother and the baby. One of the most common side effects of terbutaline is tachycardia, which means a fast or irregular heartbeat. This can lead to chest pain, palpitations, shortness of breath, and even cardiac arrhythmias or ischemia.

Therefore, the nurse should monitor the mother’s heart rate and rhythm closely when administering terbutaline.

Choice A is wrong because terbutaline does not cause hypotension, which means low blood pressure. In fact, terbutaline can increase blood pressure by constricting blood vessels.

Choice C is wrong because terbutaline does not cause hyperglycemia, which means high blood sugar. However, terbutaline can interfere with insulin secretion and glucose metabolism in some cases, especially in diabetic mothers.

Therefore, the nurse should monitor the mother’s blood sugar levels when administering terbutaline.

Choice D is wrong because terbutaline does not cause hypokalemia, which means low potassium levels in the blood. However, terbutaline can cause a temporary increase in potassium levels in the baby, which can affect the baby’s heart function.

Therefore, the nurse should monitor the baby’s heart rate and rhythm when administering terbutaline.

Normal ranges for heart rate are 60 to 100 beats per minute for adults and 120 to 160 beats per minute for fetuses.

Normal ranges for blood pressure are typically between 90/60 mmHg and 120/80 mmHg.

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Correct Answer is A

Explanation

Magnesium sulfate is a tocolytic drug that inhibits uterine activity and relaxes smooth muscles.The goal of magnesium sulfate therapy for a client who is in pre-term labor is to stop or reduce the frequency and intensity of contractions.

Choice B is wrong because the client’s blood pressure decreases to within normal limits.

Magnesium sulfate is not an antihypertensive drug and does not lower blood pressure.It is used to prevent seizures in clients with preeclampsia or eclampsia.

Choice C is wrong because the client’s deep tendon reflexes are 2+.

This is a normal finding and does not indicate the effectiveness of magnesium sulfate therapy.A decrease or loss of deep tendon reflexes may indicate magnesium toxicity, which is a serious complication that requires immediate intervention.

Choice D is wrong because the client’s urine output increases to more than 30 mL/hr.

This is also a normal finding and does not indicate the effectiveness of magnesium sulfate therapy.A decrease in urine output may indicate renal impairment or magnesium toxicity, which are both adverse effects of the drug.

The normal range for serum magnesium level is 1.5 to 2.5 mEq/L or 1.8 to 3 mg/dL.The therapeutic range for magnesium sulfate management is 5 to 8 mg/dL.

A. Administer tocolytic medication to stop contractions B. Instruct the client to empty her bladder C. Obtain informed consent from the client D. Monitor fetal heart rate and activity

Correct Answer is B

Explanation

Instruct the client to empty her bladder.This is because a full bladder can interfere with the insertion of the needle and increase the risk of injury to the bladder or the uterus.Emptying the bladder also reduces discomfort during the procedure.

Choice A is wrong because administering tocolytic medication to stop contractions is not necessary before amniocentesis.Tocolytic medication can have side effects and should only be used when there is a clear indication of preterm labor.

Choice C is wrong because obtaining informed consent from the client is not a nursing action, but a medical one.The nurse can assist in providing information and answering questions, but the final consent should be obtained by the doctor who will perform the procedure.

Choice D is wrong because monitoring fetal heart rate and activity is not a specific action before amniocentesis, but a routine part of prenatal care.Fetal heart rate and activity can be affected by many factors, such as maternal position, fetal sleep cycle, or maternal blood sugar level.

Monitoring them before amniocentesis does not provide any useful information for the procedure.

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A nurse is administering terbutaline to a client who is at 31 weeks of gestation and has pre-term labor. Which of the following findings should the nurse monitor as an adverse effect of this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

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A nurse is administering terbutaline to a client who is at 31 weeks of gestation and has pre-term labor.

Which of the following findings should the nurse monitor as an adverse effect of this medication?