82. A client, who is gravida 2, para 0 at 31 weeks' gestation, has been hospitalized for 5 days on oral terbutaline. A physician discharges the client with a prescription for terbutaline 5 mg PO q4h. When giving discharge instructions, which instruction should a nurse include?
. "Call your physician if your heart rate is higher than 120 before you take your terbutaline."
. "You can double your dose of terbutaline if you are having more than 2 contractions per hour."
. "Call your physician if your fetus moves more than 10 times per hour."
. "You can increase your activity each day if you are not fatigued."
Test-Taking Tip
Focus on a side effect of the drug: heart rate.
Content Area: Maternity, Antepartum; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
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Answer 1 is correct because terbutaline is considered to be working at a therapeutic level when a woman's resting heart rate is between 90 and 105 beats per minute. If the heart rate is higher than 120, the physician should be notified before taking the terbutaline. Answer 2 is incorrect because a client should not be doubling the dose of terbutaline without consulting her physician. Also, the client can have up to 5 contractions per hour; more than 6 contractions per hour is a reason to notify the physician. Answer 3 is incorrect because normal fetal movement is 10 or more movements per hour. There is no need to call the physician for normal fetal movement. Answer 4 is incorrect because clients with preterm labor should be resting as much as possible. It is not appropriate to instruct a client to increase her activity.