A nurse is monitoring a client with PROM at 34 weeks of gestation who is receiving tocolytic therapy.
Which of the following findings would indicate a potential adverse effect of the medication?
A.
Maternal heart rate of 110 beats per minute
B.
Maternal blood pressure of 140/90 mmHg
C.
Maternal temperature of 37.8°C (100°F)
D.
Maternal respiratory rate of 20 breaths per minute.
The correct answer and Explanation is :
The correct answer is A. Maternal heart rate of 110 beats per minute.
Explanation:
Tocolytic therapy is used to delay preterm labor, and it can have several side effects due to its pharmacological effects on the body. The most commonly used tocolytics include beta-agonists (like terbutaline), calcium channel blockers, and nonsteroidal anti-inflammatory drugs (NSAIDs).
One significant adverse effect of beta-agonists, such as terbutaline, is tachycardia. An elevated maternal heart rate, particularly above 100 beats per minute, indicates that the medication may be causing systemic stimulation of beta-adrenergic receptors. A heart rate of 110 beats per minute suggests that the patient may be experiencing this adverse effect, potentially leading to increased cardiac workload and associated complications, such as myocardial ischemia or arrhythmias.
Option B, a maternal blood pressure of 140/90 mmHg, can be concerning and may indicate hypertension, but it is not a direct effect of tocolytic therapy. Instead, it could suggest other complications like preeclampsia, which would require further evaluation but is not a specific side effect of tocolytics.
Option C, a maternal temperature of 37.8°C (100°F), indicates a mild fever. While fever may need investigation, it is not a typical side effect of tocolytics and could stem from other causes such as infection.
Option D, a maternal respiratory rate of 20 breaths per minute, falls within the normal range (12-20 breaths per minute) and is not indicative of an adverse effect from tocolytic therapy.
In summary, while other findings warrant monitoring, an elevated heart rate is a clear indicator of potential adverse effects related to tocolytic therapy, making option A the most relevant choice in this scenario.