Chapter 9 - Nursing Care of the Growing Fetus

Question 1

Define ovum

Answer 1

the term used for the egg/baby from the time of ovulation to fertilization

Question 2

Defne zygote

Answer 2

the term used for the egg/baby from the time of fertilization to implantation

Question 3

Define embryo

Answer 3

the term used for the egg/baby from the time of implantation to 5-8 weeks

Question 4

Define fetus

Answer 4

the term used for the baby from the time of 5-8 weeks to term

Question 5

Fetal growth and development can be divided into these three categories

Answer 5

pre-embryonic (0-2 wks) embryonic (3-8 wks) fetal (8wks - term)

Question 6

The window for fertilization is

Answer 6

72 hrs - 48 before ovulation and 24hrs after ovulation Therefore, to best promote pregnancy the woman should attempt fertilization 5-3 days prior to expected ovulation and 2 days after.

Question 7

Fertilization generally occurs in the

Answer 7

outer 1/3 of the fallopian tubes

Question 8

After fertilization, the zygote

Answer 8

migrates over the next 3-4 days mitotic division begins

Question 9

A zygote with large cells on the exterior and a fluid interior is termed

Answer 9

a blastocyst

Question 10

Fertilization depends on these factors

Answer 10

• equal maturation of both sperm and ovum
• ability of sperm to reach the ovum
• ability of sperm to penetrate the zona pellucida and cell membrane to acheive fertilization

Question 11

Implantation occurs after

Answer 11

8-10 days after fertilization

as many as 50% of zygotes never acheive implantation

Question 12

Spotting occuring from zygote implantation may be misinterpreted as a menstrual period. This error would cause a difference of ______ when calculating the due date

Answer 12

4 weeks late

Question 13

Human chhorionic gonadotropin (hCG) is secreted by the ______. It’s function is to…

Answer 13

• trophoblast cells of the corpus leuteum within the zygote/embryo and by the placenta
• ensures the corpus leuteum continues to produce progesterone and estrogen so that uterine endometrium can grow and vascularize

Question 14

The chorionic villi are

Answer 14

• villi that reach out from the trophoblast cells into the uterine endometrium to form the placenta
• It produces hCG, human placental lactogen (hPL), estrogen and progesterone.

Question 15

The rate of urteroplacental blood flow ranges from ____ to _____ over the course of the pregnancy

Answer 15

• 50 mL/min at 10 weeks
• 500-600 mL/min at term

Question 16

The most efficient maternal position for uterine perfusion annd placental circulation is her

Answer 16

left side.

Lying supine could cause compression of the vena cava and supine hypotension

Question 17

Progesterone is produced by the ______. Its function is to…

Answer 17

• First by the corpus luteum, the by the placenta after 12wks
• Maintenance of the endometrial lining
• appears to reduce contractility of the uterus

Question 18

Estrogen is produced by the ______. Its function is to…

Answer 18

• First by the corpus luteum, then by the placenta
• promotes mammary gland development to prepare for lactation
• stimulates uterine growth

Question 19

Human placental lactogen hPL (aka human chorionic somatoammotropin) is produced by the ______. Its function is to

Answer 19

• Placenta (6wks-peaks a term)
• promotes mammary gland growth and regulates maternal glucose, protein and fat levels

Question 20

The amniotic membrane (amnion) function is to…

Answer 20

• support and produce amniotic fluid
• produce phospholipids that initiate prostaglandins to trigger labor.

Question 21

The function of amniotic fluid is to…

Answer 21

• shield the fetus against pressure or a blow against the mother’s abdomen
• Protect the fetus from Temperature change
• Cushion the umbilical cord & fetal O₂ supply
• slighlty alkaline (7.2)
• levels fluxuate
• ranges from 800-1200mL

Question 22

Define Hydrammnios

Answer 22

excessive amniotic fluid (>2000mL)

may be caused by fetal inability to swallow or diabetes in the mother

Question 23

Define oligohydramnios

Answer 23

• reduction in amount of amniotic fluid (<300mL)
  *

Question 24

The umbilical cord should contain

Answer 24

1 vein and 2 arteries

1:1 ratio indicates chromosomal disorders (esp. kidney & heart)

Question 25

The ectoderm forms what body portions

Answer 25

• CNS
• PNS
• integument
• sense organs
• mucus membranes of anus, mouth and nose
• mammary glands

Question 26

The mesoderm forms what body portions

Answer 26

• Supporting structures (connective tissue, bone, cartilage, muscle, ligaments, tendons)
• Kidneys & ureters
• Reproductive system
• Lymph
• Circulatory systems & blood

Question 27

The endoderm forms what body portions

Answer 27

• Gi tract, Pericardial, plaural, and peritoneal cavity lining
• Repiratory tract
• Tonsils, parathyroid, thymus glands
• Bladder and urethra

Question 28

The fetal heart starts beating as early as the

Answer 28

24th day

(it can be heard via doppler by the 6th or 7th wk)

Question 29

Once stabilized, the normal fetal heart rate ranges from

Answer 29

110-160 beats/min

Question 30

At birth the infant’s pulse rate is between

Answer 30

80-140 beats/min

Question 31

The infant’s hemoglobin and hematocrit lab values are approximately

Answer 31

• hemoglobin: 17.1g/100mL
• hematocrit: 53%

Question 32

The primary test for fetal maturity is the

Answer 32

lacithin/sphingomyelin (L/S) ratio in surfactant

2:1 is normal/goal at birth