Question

As relates to the use of tocolytic therapy to suppress uterine activity, nurses should be aware that:

a. The drugs can be given efficaciously up to the designated beginning of term at 37 weeks.
b. There are no important maternal (as opposed to fetal) contraindications.
c. Its most important function is to afford the opportunity to administer antenatal glucocorticoids.
d. If the client develops pulmonary edema while receiving tocolytics, intravenous (IV) fluids should be given.

Answer 1

Tocolytic therapy is used to delay preterm labor to allow administration of antenatal glucocorticoids, enhancing fetal lung maturity, and there are maternal contraindications to its use. It should be managed carefully, especially if the patient exhibits signs of pulmonary edema.

Step-by-step explanation:

As it relates to the use of tocolytic therapy to suppress uterine activity, it's important to note that:

• While tocolytic therapy can be effective, it is generally not recommended for use up to the full term of 37 weeks.
• There are significant maternal contraindications against the usage of tocolytics, including cardiovascular disease or pulmonary edema.
• The most important function of tocolytic therapy is indeed to delay preterm labor temporarily, which provides a critical opportunity to administer antenatal glucocorticoids. These can accelerate fetal lung maturation, improving neonatal outcomes in premature births.
• Should the patient develop pulmonary edema while receiving tocolytics, decreasing or discontinuing IV fluids, not increasing them, is the indicated management to avoid exacerbating the condition.

Understanding the interplay between hormones such as progesterone, potentially decreasing in late pregnancy, and rising estrogen levels helps in grasping the rationale behind the use of tocolytics and their careful management during pregnancy.