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OB NURS 306 Chapter 3 Genetics, Conception, Fetal Development, and Reproductive Technology, Chapter 4 Physiological Aspects of Antepartum Care Chapter 12 Postpartum Physiological Assessments and Nursing Care (Chap 1 to 18) Deeply elab€16,94
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OB NURS 306 Chapter 3 Genetics, Conception, Fetal Development, and Reproductive Technology, Chapter 4 Physiological Aspects of Antepartum Care Chapter 12 Postpartum Physiological Assessments and Nursing Care (Chap 1 to 18) Deeply elab
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OB NURS 306 Chapter 3 Genetics, Conception, Fetal
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West Coast University
OB NURS 306 Chapter 3 Genetics, Conception, Fetal Development, and Reproductive Technology, Chapter 4 Physiological Aspects of Antepartum Care Chapter 12 Postpartum Physiological Assessments and Nursing Care (Chap 1 to 18) Deeply elab
Chapter 3 Genetics, Conception, Fetal Development, and Reproduc...
chapter 4 physiological aspects of antepartum care chapter 12 postpartum physiological assessments and nursi
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West Coast University
OB NURS 306 Chapter 3 Genetics, Conception, Fetal
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OB NURS 306 Chapter 3 Genetics, Conception, Fetal Development, and
Reproductive Technology, Chapter 4 Physiological Aspects of
Antepartum Care Chapter 12 Postpartum Physiological Assessments and
Nursing Care (Chap 1 to 18) Deeply elab
Chapter 3 Genetics, Conception, Fetal Development, and Reproductive Technology
Genetics study of heredity
Genomics addresses all genes and their interrelationships in order to identify their combined influence on growth and
development of the organism
o Providing better methods for preventing disease and abnormalities, diagnosing diseases, predicting health risks,
personalizing treatment plans
30,000 genes in the human genome (organism’s complete set of DNA)
46 chromosomes; 22 homologous pairs of chromosomes and one pair of sex chromosomes
genotype person’s genetic makeup
phenotype how genes are outwardly expressed (eye color, hair color, height)
recessive genetic disorders sickle cell anemia, cystic fibrosis, thalassemia, Tay-Sachs disease
carrier testing identify individuals who carry one copy of a gene mutation that, when present in two
copies causes a genetic disorder; used when there is a family history of genetic disorder
preimplantation testing/preimplantation genetic diagnosis used to detect genetic changes in embryos
that are created using assisted reproductive techniques
prenatal testing early detection of genetic disorders
risks for conceiving child with genetic disorder maternal age older than 35, man/woman who has genetic
disorder; family history of genetic disorder, history of previous pregnancy resulting in a genetic disorder or
newborn
abnormalities
refer to support group whether they wish to terminate/continue with pregnancy
sickle cell anemia
o most common of African ancestry
o sickle-cell hemoglobin forms rigid crystals that distort and disrupt RBCs; oxygen-carrying
capacity of blood is diminished
cystic fibrosis
o most common genetic disease of European ancestry
o production of thick mucus clogs in bronchial tree and pancreatic ducts
o most severe effects are chronic respiratory infections and pulmonary failure
Tay-Sach disease
o Most common among Jewish ancestry
o Degeneration of neurons and nervous system results in death by the 2 years old
PKU
o Lack of enzyme to metabolize the amino acid phenylalanine leads to severe mental and physical
o Effects may be prevented by use of a diet at beginning of birth that limits
retardation
phenylalanine
Huntington’s Disease
o Uncontrollable muscle contractions between 30-50 years followed by memory loss and personality
o No treatment that can delay mental deterioration
Hemophilia (X-linked)
o Lack of factor 8
o Can be controlled with factor 8 from donated blood
Duchenne’s Musclular Dystrophy
o Replacement of muscle by adipose or scare tissue with progressive loss of muscle function; often
fatal before age 20 due to involvement of cardiac muscle
teratogens any drugs, viruses, infections, or other exposures that can cause embryonic/fetal developmental
abnormality
degree or types of malformation vary on length of exposure, amount of exposure, and when it occurs
during human development
developing human is most vulnerable to effects of teratogens within first 8 weeks of gestation (organogenesis) can
cause gross structural defects
exposure after 13 weeks may cause fetal growth restriction or reduction of organ size
toxoplasma is a protozoan parasite found in cat feces and uncooked/rare beef and lamb
o can cause fetal demise, mental retardation, blindness when fetus is exposed
o avoid contact with cat feces and eating rare beef or lamb if pregnant or
rubella increased
attempting risk for heart defects, deafness and/or blindness, mental retardation, fetal demise
pregnancy
, 2
cytomegalovirus increased risk for hydrocephaly, microcephaly, cerebral calcification, mental retardation,
hearing loss
herpes varicella/chicken pox increased risk for hypoplasia of hands and feet, blindness/cataracts, mental
retardation
syphilis increased risk for skin, bone and/or teeth defects, fetal demise
cocaine increased risk for heart, limbs, face, GI/GU tract defects, cerebral infarctions, placental abnormalities
Chapter 4 Physiological Aspects of Antepartum Care
, 3
G/P System
o Gravida: # times a woman has been pregnancy including current pregnancy
o Para: # of births after 20 weeks’ gestation whether live or stillbirths
o Abortions are not accounted for in this system
GTPAL
o G: # times pregnancy
o T: # of term infants born after 37 weeks
o P: # of preterm infants between 20 and 37 weeks
o A: # of abortions either spontaneous or induced before 20 weeks
o L: # of living children
Nulligravida: woman who has never been pregnant or given birth
Primigravida: woman who is pregnant for the first time
Multigravida: someone who is pregnant for at least the second time
Prenatal period entire time period during which a woman is pregnant through birth of baby
Nurse places emphasis on health education and health promotion
Family-centered maternity care is a model of obstetrical care based on a view of pregnancy and childbirth
as a normal life event, a life transition that is not primarily medical but rather developmental
Low-risk population should have approximately 14-16 prenatal visits per
pregnancy
First trimester
o Woman learns frequency of follow-up visits and what to expect from pregnancy visits as
pregnancy progresses during initial visit
o Comprehensive health and risk assessment; currently pregnancy history; complete physical and
pelvic examination; nutrition assessment; psychosocial assessment; assessment for intimate partner
o Fetal heart tones are auscultated with US Doppler, initially
violence
by
o At end of 12
10 and firstweeks
trimester, fetus is 3 inches in length and weights 1-2 ounces, all organ systems are present
o Assessment of uterine growth after 10-12 weeks is measured by height of fundus with centimeter
measuring tape; zero point of tape is placed on the symphysis pubis and tape is extended to top of
fundus; MEASUREMENT SHOULD EQUAL # OF WEEKS PREGNANT
o Certain types of fish (king mackerel, shark, swordfish, tilefish) should be avoided due to
high levels of methylmercury
Second
trimester
o Chart review; interval history; focused physical assessment; pelvic exam/sterile vaginal exam if
indicated; confirm EDD
o Triple/quad screen (neural tube defect); US; screening for gestational diabetes; hemoglobin
and hematocrit; antibody screen if Rh-negative (Administration of RhoGAM if Rh-negative and
anti-body screen negative)
Administered prophylactically at 28 weeks to prevent isoimmunization from potential
exposure to Rh- positive fetal blood during normal course of pregnancy
Adverse reaction pain at IM site; fever
o Slight decrease in blood pressure toward end of
second
o Assess trimester
for quickening when the woman feels baby move for first time
o Leopold’s maneuvers to identify position of fetus
o Slight lower body edema is normal due to decreased venous return
o At 20 weeks, fetus is 8 inches long and weights 1 pound
o Increase in calorie intake by 340
kcal/day
Third trimester
o Chart review; interval history; nutrition follow-up; focused physical assessment; pelvic exam/sterile
vaginal exam if indicated
o Group B Strept at 35-37 weeks; H&H if not done in second trimester; repeat GC, chlamydia, RPR,
HIV HbSAg; 1- hour glucose challenge test at 24-28 weeks
o Record fetal movement count 10 distinct fetal movements within 2 hours is considered reassuring OR 4
movements in 1 hour
o At term, fetus is 17-20 inches long, 6-8 pounds
o Increase in calorie intake by 452
kcal/day
Chapter 6 Antepartal Tests
Chorionic villus sampling aspiration of a small amount of placental tissue for chromosomal, metabolic, or DNA
testing
Between 10 and 12 weeks
oo Tests for cystic fibrosis to detect fetal
but not abnormalities
neural tube caused by genetic disorders
defects
o Supine position for transabdominal aspiration with US to guide placement
o Lithotomy for transvaginal aspiration with US to guide placement
, 4
o Small biopsy of chorionic (placental) tissue is removed
o Assess fetal and maternal well-being post-procedure; FHR is auscultated twice in 30 minutes
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