What assessment is the highest priority for a nurse administering terbutaline to a pregnant client in preterm labor?

When administering terbutaline to a pregnant client in preterm labor, monitoring both the maternity and fetal heart rates is essential due to the medication's potential effects on both the mother and the fetus. Terbutaline is a tocolytic agent that relaxes the uterus and can be beneficial in delaying labor, but it also has side effects, including increased heart rate for both the mother and the fetus.

Fetal heart rate is particularly critical, as any significant deviation from the normal range could indicate fetal distress. This distress may occur if the drug adversely affects the fetal condition or if labor progresses despite treatment. Monitoring maternal heart rate is also crucial, as tachycardia can signal adverse reactions to the medication, necessitating reassessment of therapy.

While monitoring blood pressure, urinary output, and deep tendon reflexes are important in the broader context of maternal health and potential medication side effects—such as fluid overload or signs of preeclampsia—monitoring both maternal and fetal heart rates directly addresses the immediate risks associated with terbutaline administration. These assessments allow for timely interventions if any concerning changes are noted, making them the highest priority in this scenario.