A gravida 2 para 1 at 26 weeks with preterm labor is treated with terbutaline. Which assessment is highest priority to monitor during administration?

• A. Maternal blood pressure and respirations
• B. Hourly urinary output
• C. Maternal and fetal heart rates
• D. Deep tendon reflexes

Answer: (C)

Terbutaline tocolysis can quickly affect the cardiovascular system because it’s a beta-adrenergic agonist. The most critical thing to monitor is both maternal and fetal heart rates, because changes in heart rate directly reflect how the drug is impacting mother and baby and help you detect any adverse effects or fetal distress early. Maternal tachycardia can signal overdosage or risk for arrhythmias and pulmonary edema, while fetal tachycardia or distress may indicate compromised placental perfusion or a reaction to therapy. Detecting these changes promptly guides dose adjustment or discontinuation to protect both. While blood pressure and respirations matter, and deep tendon reflexes relate more to magnesium sulfate use, the heart rates provide the quickest, most sensitive indication of safety in this situation. Urinary output is useful for fluid status but not the priority focus here.