Page 875 - Saunders Comprehensive Review For NCLEX-RN

1. Risk of multiple births and birth defects

2. Ovarian overstimulation (abdominal pain,

distention, ascites, pleural effusion)
3. Headache, irritability
4. Fluid retention and bloating
5. Nausea, vomiting
6. Uterine bleeding
7. Ovarian enlargement
8. Gynecomastia
9. Rash
10. Orthostatic hypotension
11. Febrile reactions

C. Interventions

1. Instruct the client regarding administration of the
medication.
2. Provide a calendar of treatment days and instructions
on when intercourse should occur to increase
therapeutic effectiveness of the medication.
3. Provide information about the risks and hazards of
multiple births.
4. Instruct the client to notify the OB if signs of ovarian
overstimulation occur.
5. Inform the client about the need for regular follow-up
for evaluation.

Table 28-1

Tocolytics

Nursing
Medication, Classification, and Actions Adverse Effects
Interventions
Terbutaline—selective beta agonist that Maternal—Pulmonary edema, Administered by
2
suppresses preterm labor by activating beta 2 hypotension, hyperglycemia, and injection under the
tachycardia skin
receptors in the uterus—decreases both frequency
and intensity of contractions; primarily used to
delay birth for several hours to allow the fetus to
mature more before being born
Fetus—Tachycardia Dosing should stop
after 48 hours and
should be
interrupted if the
maternal heart rate
exceeds 120 beats per
minute
Magnesium sulfate—central nervous system Maternal—depressed respirations, Always use
depressant; relaxes smooth muscle, including the depressed DTRs, hypotension, intravenous
uterus; used to halt preterm labor contractions; extreme muscle weakness, flushing, controller device for

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