Cord Blood <2

0-1 days <6

1-2 days <8

3-7 days <12

ovum 1 day

sperm 2-3 day

fetus swallows fluid

flows free into the lungs

keeps temp. constant

cushions fetus

allows freedom of movement

Oxygenation capability

CNS function

viablity at 20 weeks

500 grams

Whartons jelly

1 vein

2 arteries; if there is only one thats a sign of congenital malformations

Ductus arterious-aortic branch

Foramen ovale-cardiac septum

Ductus veinous-hepatic vein

is immature and unable to get rid of bilirubin-jaundice

holds twice as much glycogen as adults

holds fetal iron for 5-6 months

Fetal stool

if its in amniotic fluid = distressed fetus

may get aspirationed suction nose then mouth

IgG

IgM

IgA

crosses placenta

fetus produces

colostrum

Dizygotic

Monozygotic

fraternal twins

identical twins

Resp. tract begins to develop

Neural tubes form

thyroid gland

bones/muscles

heart becomes 4 chambered

kidneys form

heart is completed, brain waves on EEG

nostrils and eyes close

kidneys function

genitalia are distinguishable

GI malformations occur omphocele

fingernails and toenails

genitalias fully differentiated

lanugo appears

can hear and respond

lecithin increases

Maternal age >35 Paternal >50

Family history

Unique ethnic disorders

missing a chromosome - 45 total

Turners syndrome

47 chromosomes

Trisomy 13/18 = death in the first year

Trisomy 21 = Down syndrome

XXY = Klinefelters

Sex linked / X linked

X linked recessive

X linked dominant

genes only carried on the X of the sperm or ovum

affected X is paired with a dominant X - color blind

very rare - either sex is affected Fragile X syndrome

can be positive 7 to 10 days after conception

pee on the stick with first void (more concentrated) if negative retest in 2 weeks

subjective data from mother

amenorrhea

fatigue

N/V

Breast changes

urinary frequency

quickening

objective data collected by examiner

Hegars sign - cervical neck flex, goodells - cervical softening, chadwicks - blushing of cervix, leukorrhea, enlargement of abdomen, chloasma, linea nigra, striae gravidarum, +pregnancy test, ballottement, Braxton Hicks

GI in pregnancy

liver/gallbladder

appetite 1st decreased, 2/3rd increased, ptyalism saliva, gingival hyperplasia, tooth loss, pyrosis-heartburn, reflux, constipation-hormones, hemorrhoids-increased strain on vessels.

stones, pruritus

generalized discomfort, round ligament pain.

1. I am pregnant - self

2. I am having a baby - baby

3. I am going to be a mother

Announcement-happy/sad/angry

Moratorium-acceptance

Focusing-role

the mother counts 2 or 3 times a day for 60 min

< 3 kicks per hour, assess further

No movement during sleep

fetal alarm signal if no movement in 12 hours

Ultrasonography: indications for use

Fetal well being test

Nursing role

FHR activity, gestational age, fetal growth, anatomy, genetic disorders, anomalies, placental position/function.

Doppler, amniotic fluid volume, biophysical profile.

Counseling and education regarding procedure.

Amniocentesis : maternal complications

fetal complications

indications for use

Use ultrasound for placement at 15-20 weeks.

Hemorrhage, fetomaternal hemorrhage, infection, labor, abruptio, damage to organs, amniotic fluid embolism.

death, hemorrhage, infection (amnionitis), direct injury from the needle, miscarriage, preterm labor, leakage of amniotic fluid.

genetic disorders, fetal maturity, hemolytic disease

Percutaneous umbilical blood sampling (PUBS)

Direst access to fetal circulation

insertion of needle direstly into a fetal umbilical vessel under ultrasound guidance.

Maternal assays

alpha-fetoprotein

coombs test

Maternal serum screened for neural tube defects. recommended for all pregnant women.  trisomy 21 associated with lower than normal MFASP

Rh compatibility; detects other antibodies for incompatibilty

Nonstress test

vibroacoustic stimulation

contraction stress test - nipple stimulated and oxytocin

15-20 minute test studies for variability needs 2 for reactive

buzzes the baby and causes a reaction

same as stress test but with stimulation to cause variability