A mother has been given terbutaline for preterm labour. Which of the following should be monitored?

AIIMS M.Sc. Nsg Entrance exam-2026

Obstetrics & Gynaecology

Medium

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

Terbutaline is a beta-adrenergic agonist used as a tocolytic to stop or slow preterm labor.
While its primary action is on beta-2 receptors in the uterus (causing relaxation), it also stimulates beta-1 receptors in the heart.
Stimulation of cardiac beta-1 receptors directly increases the heart rate, leading to tachycardia (a heart rate greater than 100 beats per minute).
Tachycardia is one of the most common, immediate, and clinically significant side effects, making maternal heart rate a priority for nursing assessment.

Option A: Bradycardia is a slow heart rate. Terbutaline is a sympathomimetic drug that stimulates the sympathetic nervous system, which leads to an increased heart rate, not a decreased one.
Option B: While terbutaline can cause hyperglycemia (high blood sugar) by promoting the breakdown of glycogen, the immediate life-threatening risks are cardiovascular. Tachycardia requires more urgent monitoring and intervention.
Option C: Hyporeflexia (decreased or absent reflexes) is not a side effect of terbutaline. It is the classic sign of toxicity from magnesium sulfate, another tocolytic agent used in obstetrics.

Visual 1: Diagram illustrating the effects of beta-agonist drugs on beta-1 (heart) and beta-2 (uterus, lungs) receptors.
Visual 2: Flowchart showing the nursing assessment steps before and during terbutaline administration for preterm labor.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Side effects and nursing monitoring for terbutaline administration in preterm labor as background academic context rather than a clinical decision trigger.
Nurses must assess maternal pulse and blood pressure before administering terbutaline to establish a baseline, and then monitor frequently (e.g., every 15-30 minutes) during administration.
A maternal heart rate consistently above 120 bpm is a common clinical threshold to withhold the medication and notify the healthcare provider to prevent severe cardiovascular compromise.
Terbutaline can also cause hypokalemia (low potassium) by driving potassium into cells. This can increase the risk of cardiac arrhythmias, especially if the patient is also taking diuretics.

How to Approach the Question

First, identify the drug mentioned in the question: Terbutaline.
Next, classify the drug. Terbutaline is a tocolytic (anti-contraction medication) and, more specifically, a beta-adrenergic agonist.
Recall the mechanism of action. Beta-agonists stimulate beta-receptors. The desired effect is on beta-2 receptors in the uterus to cause relaxation. However, they also have off-target effects.
Consider the side effects based on this mechanism. Stimulation of beta-1 receptors in the heart causes an increased heart rate (tachycardia).
Evaluate the given options. Bradycardia is the opposite effect. Hyperglycemia is a known metabolic side effect. Hyporeflexia is characteristic of a different drug (magnesium sulfate).
Prioritize the options based on clinical urgency. Cardiovascular side effects like tachycardia are often the most immediate concern and require vigilant monitoring. Therefore, tachycardia is the most critical parameter to monitor.

Concept Tested & Keywords

Concept Tested: Side effects and nursing monitoring for terbutaline administration in preterm labor.
Stem keywords: terbutaline, preterm labour, monitored
Lead-in keywords: Which of the following

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