Bronchodilator

• Assess lung sounds, respiratory pattern, pulse, and BP before administration and during peak of medication. Note amount, color, and character of sputum produced, and notify health care professional of abnormal findings.

• Monitor pulmonary function tests before initiating therapy and periodically throughout therapy to determine effectiveness of medication.

• Monitor maternal pulse and BP, frequency and duration of contractions, and fetal heart rate. Notify health care professional if contractions persist or increase in frequency or duration or if symptoms of maternal or fetal distress occur. Maternal side effects include tachycardia, palpitations, tremor, anxiety, and headache.

» Assess maternal respiratory status for symptoms of pulmonary edema (increased rate, dyspnea, rales/crackles, frothy sputum).

» Monitor mother and neonate for symptoms of hypoglycemia (anxiety; chills; cold sweats; confusion; cool, pale skin; difficulty in concentration; drowsiness; excessive hunger; headache; irritability; nausea; nervousness; rapid pulse; shakiness; unusual tiredness; or weakness) and mother for hypokalemia (weakness, fatigue, U wave on ECG, arrhythmias).

• May cause transient ↓ in serum potassium concentrations with higher than recommended doses.

» Monitor maternal serum glucose and electrolytes. May cause hypokalemia and hypoglycemia. Monitor neonate's serum glucose, because hypoglycemia may also occur in neonates.

• Symptoms of overdose include persistent agitation, chest pain or discomfort, decreased BP, dizziness, hyperglycemia, hypokalemia, seizures, tachyarrhythmias, persistent trembling, and vomiting.

» Treatment includes discontinuing beta-adrenergic agonists and symptomatic, supportive therapy. Cardioselective beta blockers are used cautiously, because they may induce bronchospasm.