week 3 Flashcards
Pre Embryonic Stage
conceiving to 2nd week
Embryonic Stage
2nd week to 8th week
Fetal stage
8th week until birth
Week 3 Gestation
dvlp brain and spinal cord
heart and GI tract begin developing
leg and arm buds are present
Week 4 Gestation
Brain differentiates
limbs develop
stomach liver and pancreas begin
Week 5 gestation
HB has reg rhythm
eyes, ears and cranial nerves begin appearing
muscles become innervated
Week 6 gestation
formation of lungs
circulation; liver produces RBC
primative skeleton formed
brain waves detectable
Week 7 gestation
straightening of trunk
nipples, hair follicles form
elbows and toes visible; limbs begin moving
diaphragm formed
fetal HB
mouth with lips present
week 8 gestation
rotation of intestines
facial features
resembles a human
week 9-12 gestation
sexual differences
buds for teeth present
digestive syst with activity
face and neck formed
urine produced and excreted
sex is determined by wk 12
digits well formed
week 13-16 gestation
fetal skin is transparent
bones harden
sucking motion
amniotic fluid swallowed
nails present
week 17-20 gestation
heart tones heard with stethoscope
eyebrows and head hair
brown fat deposited
muscles well developed
week 21-24 gestation
palmar grasp and startle reflex
alveoli form
body lean and well proportioned
skin is red and translucent
lungs produce surfactant
week 25-28 gestation
15 inches in length
rapid brain development
eyelids open and close
NS controls some functions
fingerprints present
assumes head down position
Week 29-30 gestation
^in body fat
^ in CNS control
lungs not fully mature
fetus stores iron, ca and P
week 33-38 gestation
testes in scrotum
small breast buds present
receives antibodies from mom
considered full term at 38 weeks
whats the antibody used for pregnancy tests
HcG
Nägele’s rule used to estimate date of delivery:
Subtract 3 months and add 7 days to first day of last menstrual period; then add 1 year if appropriate.
Gravidity
Refers to number of pregnancies; gravida refers to a pregnant woman
Parity
Refers to number of births past 20th week of gestation, whether fetus is born alive or not
Use of GTPAL
Gravidity
Term births (longer than 37 weeks’ gestation)
Preterm births (before 37 weeks’ gestation)
Abortions or miscarriages (if before 20th week of gestation; if not, then counts as parity)
Living: Current living children
Janelle is a 38-year-old who is currently pregnant with twins. She has a 14-year-old son who was born at 32 weeks, a 16-year-old daughter who was born on her due date and a 20-year-old daughter who was born at 41 weeks. She had one elective pregnancy termination and a miscarriage at 11 weeks.
What is her GTPAL?
G4T2P1A2L3
Presumptive Pregnancy Signs
quickening (fetal movement)
Probable signs
Hegar’s sign: a non-specific indication of pregnancy that is characterized by the compressibility and softening of the cervical isthmus
Goodell’s sign: (a softening of the cervix at around six to eight weeks of gestation
Chadwick’s sign: is a non-specific, early sign of pregnancy that is typically characterized by a bluish discoloration of the cervix, vagina, and vulva. The Chadwick sign can typically be observed as early as six wks
Ballottement:a technique of feeling for a movable object in the body, esp confirmation of pregnancy by feeling the rebound of the fetus following a quick digital tap on the wall of the uterus.
positive signs
fetal HR
Active movement palpable by examiner
Ultrasound
Fundal Height Measurements
At 16 weeks, fundus halfway between symphysis pubis and umbilicus
At 20-22 weeks, fundus at location of umbilicus
At 36 weeks, fundus at xiphoid process
Antepartum Diagnostic Testing
If result Rh negative and negative antibody screen
Will need to repeat antibody screen
Should be given Rho(D) immune globulin (RhoGAM) at 28 weeks of gestation
Prenatal Visits
Every 4 weeks up to 28 weeks
Every 2 weeks from 29 to 36 weeks
Every week from 37 weeks to birth
Assessments
Weight and BP compared with baseline values
Urine testing for protein, glucose, ketones, and nitrites
Fundal height
Quickening/fetal movement
Fetal heart rate
Teaching: danger signs
Rubins 4 maternal Tasks of pregnancy
1.Seeking safe passage for herself and her fetus
2.Securing acceptance of herself as a mother and for her fetus
3. Learning to give of self and to receive the care and concern of others
4.Committing herself to the child as she progresses through pregnancy
folic acid importance
Folic acid intake is important in the periconceptual period.
Neural tube defects are more common in infants of women with poor folic acid intake.
3 major causes of maternal death
Hypertensive disorders
Infection
Hemorrhage
third trimester assessment
Indications
Fetal movement counting
Fetal responses to hypoxia and asphyxia
Variability
Electronic fetal monitoring
Nonstress test (NST)
Antepartal Assessment Using Electronic Fetal Monitoring
contraction stress test
nipple stim contraction test
oxytocin stim contraction test
ultrasound
antepartal assessment for risks
Tests may show suspected fetal compromise, deterioration of maternal condition, or both.
Third-trimester women are concerned about protecting themselves and their fetuses and consider themselves vulnerable