Question

The client is taking Terbutaline (Brethine) for premature labor. Which finding needs to be reported to the physician? ? A. Respiratory rate of 14 per minute ? B. Blood pressure of 110/40 ? C. Pulse rate of 120 per minute ? D. Temperature of 37° centigrade

Short answer

Answer: C) Pulse rate of 120 per minute

Step-by-step solution

Find out the normal range of vital signs for an adult

It's important to have a clear understanding of the standard range of vital signs to recognize any abnormalities. The normal ranges for adults are as follows: - Respiratory rate: 12-20 breaths per minute - Blood pressure: 90-120/60-80 - Pulse rate: 60-100 beats per minute - Temperature: 36.5° - 37.2° centigrade

Understand the intended effects and side effects of Terbutaline (Brethine)

Terbutaline (Brethine) is a bronchodilator and belongs to the beta-agonist class of drugs. It is used to treat premature labor as it can help relax the uterus muscles. However, it can also affect other smooth muscles like the bronchial and vascular smooth muscles, which can result in some side effects like tachycardia (increased heart rate), palpitations, anxiety, tremors, and chest pain. It's crucial to consider these potential side effects when evaluating the vital sign findings.

Evaluate the findings based on standard range and side effects of the medication

Now, let's examine the findings given in the question and compare them with the normal ranges and the side effects of Terbutaline (Brethine). - A. Respiratory rate of 14 per minute: falls within the normal range (12-20 breaths per minute) and is not a side effect of the medication. - B. Blood pressure of 110/40: the systolic pressure falls within the normal range (90-120), but the diastolic pressure is lower than the normal range (60-80). It's essential to monitor the blood pressure, but it's not a direct side effect of the medication. - C. Pulse rate of 120 per minute: higher than the normal range (60-100 beats per minute) and is a known side effect (tachycardia) of Terbutaline (Brethine). - D. Temperature of 37° centigrade: falls within the normal range (36.5° - 37.2° centigrade) and is not a side effect of the medication.

Determine the appropriate finding to report to the physician

Based on the comparisons in Step 3, the finding that is both abnormal and related to the side effects of Terbutaline (Brethine) is option C, a pulse rate of 120 per minute. This increased heart rate (tachycardia) may indicate an adverse reaction to the medication and should be reported to the physician.

Key concepts

Terbutaline for Premature Labor

Terbutaline, marketed under names such as Brethine, is a medication designed to manage premature labor by targeting the muscles of the uterus. It operates within a category of drugs known as beta-agonists. Its key function is to promote muscle relaxation, which in turn can delay birth for several vital weeks, allowing the fetus more time to develop.

As a beta-agonist, Terbutaline mainly affects the beta-2 receptor subtype, which is abundant in the uterus and lungs. This dual action not only eases uterine contractions but can also make breathing easier by dilating the airways, a feature that earmarks it as a potential treatment for asthma.

However, Terbutaline’s effect is not confined solely to the uterus, but it also impacts cardiovascular and other smooth muscle systems due to a phenomenon known as pharmacologic side effects. Let's delve into the consequence this has on monitoring patient vital signs and the importance of being vigilant for signs of medication side effects.

Evaluating Vital Signs

The evaluation and monitoring of vital signs play a critical role in the medical field, serving as fundamental indicators of a patient's health. For a patient taking Terbutaline for premature labor, it is particularly important to monitor these signs attentively. These vital signs include respiratory rate, blood pressure, pulse rate, and temperature.

With brethine use, specific attention should be paid to the heart rate, or pulse, and blood pressure. An adult's average respiratory rate should remain between 12 to 20 breaths per minute, blood pressure within the range of 90-120/60-80 mmHg, a pulse rate of 60-100 beats per minute, and a body temperature between 36.5° and 37.2° centigrade. Any significant deviations from these norms, particularly in response to medication, should prompt health care professionals to evaluate whether these changes are connected to the drug's side effects or an indication of another health issue.

Medication Side Effects

While medications like Terbutaline are vital in the management of conditions such as premature labor, it is paramount to be aware of their side effects. Side effects from such medications can range from mild to severe and can impact various parts of the body. In the case of Terbutaline, common side effects relate to its beta-agonistic activity which is not exclusive to the uterus but also influences the cardiovascular system.

The pivotal side effect of concern for health practitioners is an increased heart rate or tachycardia. This response is the body's reaction to the drug's stimulation of beta receptors beyond the uterus, including those found in the heart. Other side effects may include palpitations, anxiety, tremors, and chest pain, which should be observed and reported if they compromise patient comfort or safety.

Thus, when a patient on Terbutaline exhibits augmented pulse rate—as highlighted in the exercise—it may be a clear signal of the drug’s cardiac-related side effects, warranting immediate medical attention to prevent complication.