Fetal Environment

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Included In This Lesson

Study Tools For Fetal Environment

Placenta in Uterus (Image)
Placenta (Image)
Chorion and Amniotic Sac (Image)
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Outline

Overview

  1. Important structures form the optimal fetal environment
    1. Amnion
    2. Chorion
    3. Amniotic Fluid
    4. Placenta

Nursing Points

General

  1. Drugs, nutrients, ETOH, viruses, and antibodies can pass through placenta
  2. Larger particles, like bacteria, cannot pass through placenta
  3. Amniotic sac and mucus plug act as a barrier to keep toxins from passing through the cervix

Assessment

  1. Amnion
    1. Inner membrane that forms the amniotic sac that later surrounds the embryo/fetus
  2. Chorion
    1. Outer membrane that forms the fetal side of the placenta
    2. Eventually develops vascular structures
    3. Forms placenta
  3. Amniotic fluid
    1. Cushions, protects, temperature control
    2. Fetus will swallow amniotic fluid, urinate it out, and move it through their respiratory system
      1. Doesn’t provide nutrients
  4. Placenta
    1. Fully formed at 10 weeks and at 12 weeks produces hormones
    2. It’s an organ!
    3. Provides gas exchange, exchange of nutrients and waste products between mom and baby

Therapeutic Management

  1. Management will revolve around ensuring the environment is safe for fetal development
    1. No alcohol, illegal drugs, or medications that are unsafe in pregnancy
    2. Healthy diet
    3. Hydration
  2. Making sure proper development of the fetal environment occurs or it will not be viable

Nursing Concepts

  1. Reproduction
  2. Human development

Patient Education

  1. Safe medications
  2. No alcohol
  3. Prenatal vitamins

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ADPIE Related Lessons

Related Nursing Process (ADPIE) Lessons for Fetal Environment

Transcript

In this lesson I will explain the effects of the environment on the fetus and your role in helping to create a safe environment.

The fetal environment is crucial for fetal development. The fetal environment is composed of the amnion, chorion amniotic fluid, and placenta. So let’s just first review that for all of this environment to develop implantation has occurred. The blastocyst has implanted into the endometrium. So from this the amnion and chorion will form. The amnion will form from the Inner membrane of this will develop into the amniotic sac that will later surrounds the embryo/fetus. The chorio is the outer membrane and this will form the fetal side of the placenta. The chorion develops vascular structures that form chorionic villi and forms placenta. These chorionic villi think of them as finger like projections that really grab hold and maximize contact with maternal blood. This will help increase the ability to get nutrients to the fetus from the maternal blood. Amniotic fluid is the next component of the fetal environment. Fluid fills the sac mostly from maternal fluids but then further into the pregnancy the fetus swallows the fluid and voids and the amniotic fluid becomes composed of fetal urine. The amniotic fluid is provides cushion, protection, temperature control and supports fetal development. So let’s look at each of these. Its a cushion because its a bag of water so this offers support as the mother is moving around. It provides protection because it is a barrier. It is sealed so nothing can get in. Think of a water balloon. Nothing can get in or out until it pops. It helps with fetal development in so many ways. The fetus can move around and this helps with muscle development and growth. The fetus will do practice breaths with the amniotic fluid to develop the lungs. This will also provide a stable temperature environment for the fetus because it regulates its own temperature. Last is the placenta. So remember the placenta forms from the chorion. The placenta will be fully formed at 10 weeks and at 12 weeks it takes over hormone production. The placenta is an organ! It will provides gas exchange, exchange of nutrients and waste products between mom and baby.
Now that the fetal environment is developed let’s look at different things that might be able to invade the safe environment. So drugs, alcohol, and viruses and antibodies can cross the placenta. So of those antibodies can help the fetus in the environment but drugs, alcohol and viruses could cause harm. Bacteria is a larger particle so it cannot pass through placenta. Barriers are so important for protection. So again the amniotic sac is sealed and will keep things out. There is also a mucus plug that acts as a barrier to keep toxins from passing through the cervix Think of this as a cork So you have the uterus that is filled with the amniotic sac and there is a cork which is an extra barrier to keep things out. So in this image at the base of the uterus in the cervix is where the plug is located.
Our management and education aren’t going to be too much at this time. The patient usually is not even aware that she is pregnancy yet. So management will revolve around ensuring the environment is safe for fetal development. Make sure the mother is not consuming alcohol or using illegal drugs or medications that could cross the placenta and be harmful. We also need to make sure proper development of the fetal environment occurs .If this environment doesn’t develop properly then it will not be viable.
Education needs to revolve around ensuring they are taking prenatal vitamins and that there is no drinking alcohol as well as that medications they are taking are safe. It is also good to ensure they have a list of safe over the counter medications that they can take during pregnancy.

Our nursing concepts for this patient are reproduction and human development because reproduction has occurred and this environment is necessary for human development.
Ok so our key points to bring it all together are that the amnion, chorion, amniotic fluid, and placenta are part of the fetal environment. The amnion is going to form the outer membrane and enclose the embryo making the embryonic sac. The chorion is going to develop into the placenta from the inner membrane. The amniotic fluid is going to provide a barrier, a cushion, temperature control, and support fetal growth and development. The placenta is an organ! At 12 weeks it will produce hormones and it provides the gas exchange and nutrients to the fetus. So now the the things that can cross the placenta and cause harm. Alcohol, drugs, viruses can all cross. These are legal and illegal drugs. Some medications are safe and some are not.

Make sure you check out the resources attached to this lesson and review how all these pieces of the environment play a vital role in fetal development. Now, go out and be your best selves today. And, as always, happy nursing.

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Maternal-Newborn Nursing Study Plan

Concepts Covered:

  • Pregnancy Risks
  • Labor Complications
  • Newborn Complications
  • Fetal Development
  • Terminology
  • Prenatal Concepts
  • Newborn Care
  • Labor and Delivery
  • Postpartum Care
  • Postpartum Complications
  • Medication Administration
  • Studying
  • Communication

Study Plan Lessons

Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placentae (Placental abruption)
Acyclovir (Zovirax) Nursing Considerations
Addicted Newborn
Adult Vital Signs (VS)
Alpha-fetoprotein (AFP) Lab Values
Ampicillin (Omnipen) Nursing Considerations
Anemia in Pregnancy
Antepartum Testing
Antepartum Testing Case Study (45 min)
Anti-Infective – Aminoglycosides
Anti-Infective – Lincosamide
Babies by Term
Behind The Red Line – Live Tutoring Archive
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone in Pregnancy
Bicarbonate (HCO3) Lab Values
Blood Cultures
Blood Glucose Monitoring
Blood Transfusions (Administration)
Body System Assessments
Breastfeeding
Butorphanol (Stadol) Nursing Considerations
Cardiac (Heart) Disease in Pregnancy
Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)
Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)
Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)
Certified Nurse Midwife
Chorioamnionitis
Clindamycin (Cleocin) Nursing Considerations
Congestive Heart Failure (CHF) Labs
Day in the Life of a Labor Nurse
Day in the Life of a Postpartum Nurse
Dexamethasone (Decadron) Nursing Considerations
Direct Bilirubin (Conjugated) Lab Values
Discomforts of Pregnancy
Disseminated Intravascular Coagulation (DIC)
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Dystocia
Ectopic Pregnancy
Ectopic Pregnancy Case Study (30 min)
Emergent Delivery (OB) (30 min)
Epidural
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythroblastosis Fetalis
Eye Prophylaxis for Newborn
Eye Prophylaxis for Newborn (Erythromycin)
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Family Planning & Contraception
Family Planning & Signs of Pregnancy – Live Tutoring Archive
Fertilization and Implantation
Fetal Alcohol Syndrome (FAS)
Fetal Circulation
Fetal Development
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Environment
Fetal Heart Monitoring (FHM)
Fetal Heart Monitoring Like A Pro – Live Tutoring Archive
Fetal Heart Monitoring Like A Pro 2 – Live Tutoring Archive
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fundal Height Assessment for Nurses
Furosemide (Lasix) Nursing Considerations
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes (GDM)
Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive
Gestational HTN (Hypertension)
Glucagon Lab Values
Glucose Tolerance Test (GTT) Lab Values
Gravidity and Parity (G&Ps, GTPAL)
HELLP Syndrome
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hemodynamics
Hemoglobin A1c (HbA1C)
Hepatitis B Vaccine for Newborns
Homocysteine (HCY) Lab Values
Hydatidiform Mole (Molar pregnancy)
Hydralazine (Apresoline) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Hyperbilirubinemia (Jaundice)
Hyperemesis Gravidarum
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hypovolemic Shock Case Study (OB sim) (60 min)
Incompetent Cervix
Infections in Pregnancy
Initial Care of the Newborn (APGAR)
Inserting a Foley (Urinary Catheter) – Female
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Isotonic Solutions (IV solutions)
Labor Progression Case Study (45 min)
Leopold Maneuvers
Lung Surfactant
Lung Surfactant for Newborns
Magnesium Sulfate
Magnesium Sulfate
Magnesium Sulfate (MgSO4) Nursing Considerations
Magnesium Sulfate in Pregnancy
Mastitis
Maternal Risk Factors
Mechanisms of Labor
Meconium Aspiration
Meds for Postpartum Hemorrhage (PPH)
Meds for PPH (postpartum hemorrhage)
Menstrual Cycle
Methylergonovine (Methergine) Nursing Considerations
Newborn of HIV+ Mother
Newborn Physical Exam
Newborn Reflexes
Nifedipine (Procardia) Nursing Considerations
Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Chorioamnionitis
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Dystocia
Nursing Care Plan (NCP) for Ectopic Pregnancy
Nursing Care Plan (NCP) for Gestational Diabetes (GDM)
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for Hyperemesis Gravidarum
Nursing Care Plan (NCP) for Hypertension (HTN)
Nursing Care Plan (NCP) for Incompetent Cervix
Nursing Care Plan (NCP) for Mastitis
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Meconium Aspiration
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Newborns
Nursing Care Plan (NCP) for Placenta Previa
Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)
Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)
Nursing Care Plan (NCP) for Preterm Labor / Premature Labor
Nursing Care Plan (NCP) for Process of Labor
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)
Nursing Care Plan for Newborn Reflexes
Nursing Case Study for Maternal Newborn
Nutrition Assessments
Nutrition in Pregnancy
Nutritional Requirements
OB (Labor) Nurse Report to OB (Postpartum) Nurses
OB Course Introduction
OB Non-Stress Test Results Nursing Mnemonic (NNN)
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Obstetrical Procedures
Opioid Analgesics in Pregnancy
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Oxytocin (Pitocin) Nursing Considerations
Pediatric Vital Signs (VS)
Physiological Changes
Phytonadione (Vitamin K)
Phytonadione (Vitamin K) for Newborn
Placenta Previa
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Postpartum Discomforts
Postpartum Hematoma
Postpartum Hemorrhage (PPH)
Postpartum Interventions
Postpartum Physiological Maternal Changes
Postpartum Thrombophlebitis
Precipitous Labor
Preeclampsia (45 min)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Labs
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Preload and Afterload
Premature Rupture of the Membranes (PROM)
Preterm Labor
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Process of Labor
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Process of Labor – Live Tutoring Archive
Process of Labor 2 – Live Tutoring Archive
Prolapsed Umbilical Cord
Promethazine (Phenergan) Nursing Considerations
Prostaglandins
Prostaglandins in Pregnancy
Protein (PROT) Lab Values
Retinopathy of Prematurity (ROP)
Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
Signs of Pregnancy – Live Tutoring Archive
Signs of Pregnancy (Presumptive, Probable, Positive)
Spironolactone (Aldactone) Nursing Considerations
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Subinvolution
Terbutaline (Brethine) Nursing Considerations
Tips & Advice for Newborns (Neonatal IV Insertion)
Tocolytics
Tocolytics
Top 5 Misunderstood OB Concepts – Live Tutoring Archive
Transient Tachypnea of Newborn
Umbilical Cord Vasculature Nursing Mnemonic (2A1V)
Uterine Stimulants (Oxytocin, Pitocin)
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
What the Heck is Antepartum Testing? – Live Tutoring Archive