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Ectoderm has started to develop the brain and spinal cord. The gastrointestinal tract is developed from the endoderm.
A rudimentary heart has developed and has started to be
Embryonic shape becomes cylindrical, forming a "C." The upper respiratory tract begins to develop, and the ears and eyes form.
Embryo is approximately 3/8 in. in length. The head is growing because of the rapidly developing brain. The heart has four chambers.
Embryonic length is approximately 1/2 in. The liver is beginning to form red blood cells. Facial development becomes more defined.
Arms and legs become more clearly defined.
Embryo is approximately 1 in. and has a definite human form. Eyes begin to fuse. External genitalia begin to differentiate. The rectal passage opens.
All systems continue to refine themselves.
The fetus is now considered post-term; amniotic fluid volume diminishes and placental function diminishes, either or both of which can result in fetal and neonatal morbidity and death.
around 16 cells and development forming a central fluid cavity around a cell mass called the blastocyst, which will become the embryo and the embryonic membrane
The outer layer of cells around the fluid cavity replaces the zona pellucida
will become the outer membrane, or the chorion. The chorion will overlay the amnion, and these will form the amniotic sac that encases the products of conception and hold the amniotic fluid.
The pancreas secretes additional insulin to compensate for the antagonistic effects of hPL. Failure to compensate for this effect can result in gestational diabetes mellitus.
Pregnancy can also affect the urinary tract, musculoskeletal, and central nervous systems.
In the genitourinary system,
Positive signs of pregnancy are diagnostic indicators that cannot be attributed to anything else but pregnancy, including:
If the crisis is not resolved, maladaptive behaviors may occur with the possible disintegration of the family. Resolving the maturational crisis allows the family to return to normal functioning and strengthens family relationship bonds.
- A weaned toddler may ask to drink from a bottle or nurse.
- Toilet trained children may wet clothes or linen.
Increased levels of hCG
Changes in carbohydrate metabolism
Avoid odors or causative factors.
Eat dry crackers or toast before arising in morning.
Have small but frequent meals.
Avoid greasy or highly seasoned foods.
Take dry meals with fluids between meals.
Drink carbonated beverages.
Pressure of uterus on bladder in both first
and third trimesters
Void when urge is felt.
Increase fluid intake during the day.
Decrease fluid intake only in the evening to
Specific causative factors unknown
May be aggravated by nocturia due to
Plan time for a nap or rest period daily.
Go to bed early.
Seek family support and assistance with
responsibilities so that more time is available to rest.
ncreased levels of estrogen and progesterone
Wear well-fitting, supportive bra
Hyperplasia of vaginal mucosa and
increased production of mucus by the
endocervical glands due to the increase in
Promote cleanliness by daily bathing.
Avoid douching, nylon underpants, and pantyhose;
cotton underpants are more absorbent; powder can
be used to maintain dryness if not allowed to cake.
Ultrasound Use During the First Trimester
If the NTT result is abnormal, amniocentesis is necessary to confirm or diagnose the condition.
The advantages to NTT are that it is noninvasive and can be performed early in the pregnancy. However, NTT is not a diagnostic tool and can provide false-positive results.
A biophysical profile uses electronic fetal monitoring and ultrasound to evaluate fetal well-being, using both acute and chronic markers of fetal well-being.
A biophysical assesses five biophysical variables, which are:
3½–5 lb (1.6–2.2 kg) during first trimester then approximately 1 lb (0.45 kg)/week
25–35 lb (11.5–16 kg)
The nurse will ensure that specific laboratory studies are conducted on the pregnant woman to determine her current health status and possible risks.
Initial lab assessments include:
The nurse should also ask the woman about psychosocial support, including any cultural or spiritual preferences that should be incorporated into her plan of care. The couple should be asked about any birthing plan they may have, and should be assessed for their understanding of the labor and birthing process. Client teaching should be provided accordingly. Obtaining this information will greatly enhance the nurse’s ability to provide individualized care. Finally, proper documentation of the assessment should be completed per institutional protocol, and the health care provider notified.
During transition, low-risk women will be assessed for uterine activity and FHR every 15–30 min; for high-risk women, every 15 min.
The nurse and the woman’s partner or significant other can reassure her by praising her efforts and keeping her apprised of her progress, thus reducing her anxiety
Offering her ice chips and changing her gown and underpads may also make her more comfortable
Nursing responsibilities in the second stage include:
The nurse will begin to monitor vital signs every 15 min until any perineal repair is complete. Perineal care can then be provided with a warm water wash, and peripads applied. An ice pack can be applied to an episiotomy or laceration repair.
Providing comfort during the initial postpartum period involves addressing pain, discomfort, nutritional needs, and rest. Nursing interventions to address these needs are as follows:
Involution of the uterus is the primary change that occurs during the postpartum period. Involution is the return of the uterus to its prepregnancy state. Involution requires:
Lochia is the vaginal discharge that occurs after birth; it consists of blood, decidua, and mucus. There are three classifications of lochia:
Lochia should decrease steadily over time and move sequentially through these stages. Any sudden increase in bleeding, passage of clots, or soaking of a pad in an hour or less should be reported to the nurse or healthcare provider.
Rubella vaccine: live virus vaccine for women who are nonimmune (titer of ≥ 1:8 = immunity).
Conduction is heat loss due to direct contact with cooler objects. This can occur when newborns are placed on objects such as scales or if cool objects such as stethoscopes are placed on their skin. To avoid this type of heat loss, a warm blanket can be placed on scales or other cool objects before placing the newborn on them. Nurses can also warm stethoscopes before placing them on the newborn’s skin.
Convection is the transfer of heat to the air surrounding the newborn. This can occur with drafts and air conditioning. Nurses can prevent this heat loss by convection by keeping the newborn out of the way of drafts and keeping the environment warm.
Allows the newborn to use his or her own resources to console himself. Self-quieting activities include fist or tongue sucking.
The newborn’s ability to process and respond to repeated stimuli. After responding to the initial stimuli, the newborn learns to ignore repeated stimulation.
This is the newborn’s ability to respond to and visually fixate on appealing stimuli such as family faces. This capacity allows the newborn to become familiar with family and surroundings.
Refers to how the newborn will respond to auditory stimuli. Newborns have acute hearing and prefer the sound of human voices to nonhuman sounds. A newborn will respond to an appealing sound by turning toward it.
The newborn’s sense of smell develops rapidly after birth; by the first week of life the newborn can distinguish the smell of his or her mother from that of other mothers.
The newborn has a developed sense of taste, preferring sweet tastes. Sweet tastes increase the sucking motions.
Refers to the newborn’s sensitivity to touch. Being held, cuddled, or swaddled are ways that newborns are soothed and are able to interact with the environment.
It is best to obtain vital signs when the infant is at rest. The blood pressure of healthy, term newborns may not routinely be measured. However, blood pressure should be measured on infants with suspected cardiac anomalies, infants in distress, or premature infants.
Risk factors for neonatal sepsis include prematurity; a maternal history of rupture of membranes for longer than 18 hr; long difficult labor; maternal history of infection (cytomegalovirus, toxoplasmosis, sexually transmitted infections, or chorioamnionitis); illicit drug use; or multiple sexual partners.
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