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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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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Concepts Covered:

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Study Plan Lessons

Proton Pump Inhibitors
SSRIs
TCAs
Vasopressin
Anti-Infective – Penicillins and Cephalosporins
Metronidazole (Flagyl) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Nitro Compounds
NSAIDs
Parasympatholytics (Anticholinergics) Nursing Considerations
Hydralazine (Apresoline) Nursing Considerations
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Corticosteroids
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Epoetin Alfa
Parasympathomimetics (Cholinergics) Nursing Considerations
Benzodiazepines
Calcium Channel Blockers
Cardiac Glycosides
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
ACE (angiotensin-converting enzyme) Inhibitors
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Atypical Antipsychotics
Atypical Antipsychotics
Injectable Medications
Injectable Medications
IV Infusions (Solutions)
Complex Calculations (Dosage Calculations/Med Math)
Renin Angiotensin Aldosterone System
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Oral Medications
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Essential NCLEX Meds by Class
6 Rights of Medication Administration
The SOCK Method – Overview
12 Points to Answering Pharmacology Questions
12 Points to Answering Pharmacology Questions
54 Common Medication Prefixes and Suffixes
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Communicable Diseases
Disasters & Bioterrorism
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Cultural Care
Environmental Health
Technology & Informatics
Epidemiology
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Alcohol Withdrawal (Addiction)
Grief and Loss
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
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Depression
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Somatoform
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Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Burn Injuries
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Diabetes Management
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Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology for Hyperthyroidism
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Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Cushings Syndrome
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Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Oncology Important Points
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Addisons Disease
Blood Transfusions (Administration)
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Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
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Artificial Airways
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ABG (Arterial Blood Gas) Interpretation-The Basics
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
ABGs Nursing Normal Lab Values
Varicella – Chickenpox
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Attention Deficit Hyperactivity Disorder (ADHD)
Scoliosis
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Growth & Development – School Age- Adolescent
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Fundal Height Assessment for Nurses
Gravidity and Parity (G&Ps, GTPAL)
Gestation & Nägele’s Rule: Estimating Due Dates
Family Planning & Contraception
Antepartum Testing
Discomforts of Pregnancy
Physiological Changes
Maternal Risk Factors
Gestational Diabetes (GDM)
Chorioamnionitis
Nutrition in Pregnancy
Gestational HTN (Hypertension)
Hydatidiform Mole (Molar pregnancy)
Ectopic Pregnancy
Disseminated Intravascular Coagulation (DIC)
Fetal Development
Infections in Pregnancy
Mechanisms of Labor
Process of Labor
Fetal Circulation
Fetal Environment
Placenta Previa
Prolapsed Umbilical Cord
Fetal Heart Monitoring (FHM)
Leopold Maneuvers
Precipitous Labor
Preterm Labor
Abruptio Placentae (Placental abruption)
Breastfeeding
Postpartum Discomforts
Postpartum Physiological Maternal Changes
Dystocia
Initial Care of the Newborn (APGAR)
Mastitis
Postpartum Hemorrhage (PPH)
Newborn Reflexes
Body System Assessments
Newborn Physical Exam
Transient Tachypnea of Newborn
Meconium Aspiration
Babies by Term
Newborn of HIV+ Mother
Hyperbilirubinemia (Jaundice)
Head to Toe Nursing Assessment (Physical Exam)
Blood Glucose Monitoring
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Bowel Elimination
Pain and Nonpharmacological Comfort Measures
Hygiene
Intake and Output (I&O)
Patient Positioning
Complications of Immobility
Urinary Elimination
Defense Mechanisms
Abuse
Overview of Developmental Theories
Overview of Developmental Theories
Prioritization
Triage
Overview of the Nursing Process
Therapeutic Communication
Isolation Precaution Types (PPE)
Maslow’s Hierarchy of Needs in Nursing
Delegation
Fall and Injury Prevention
HIPAA
Brief CPR (Cardiopulmonary Resuscitation) Overview
Fire and Electrical Safety
Advance Directives
Legal Considerations
Drawing Pictures
Duplicate Facts
Repeating Words
Denying Feelings
NCLEX® Question Traps
Outline Question Method (Note taking)
Priority
Nursing Process
Acute vs Chronic
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What is the NCLEX?
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SATA
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Bloom’s Taxonomy
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