Pre-embryonic + Neonate

Ectoderm

nervous system, epidermis

mesoderm

bones, muscle, connective tissue

endoderm

GI, respiratory, urinary, endocrine

Embryonic

essentials developed, most vulnerable to teratogenic substances. Essentials: placenta, umbilical cord, amnionic fluid

Embryonic: 3 weeks

neural tube forms (primitive spinal cord), beginning brain, heart, and spinal cord.

Embryonic: 4 weeks

brain differentiates, limb buds

Embryonic: 5 weeks

heart pumps blood, muscles in backbone, respiratory, and digestive track

Embryonic: 6 weeks

Fetal circulation established, eye forms, nasal cavity/upper lip form

Embryonic: 7 weeks

Palate of mouth nearly completely formed, fetal heartbeat can be heard on ultrasound.

Embryonic: 8 weeks

major body systems formed, body can move

Fetal: 9-12 weeks

urine produced + secreted, ossification of bones, respiratory like movements, natal genitalia recognizable.

Fetal: 13-16 weeks

placenta is distinct, heart circulates blood well, quickening happens towards end

Fetal: 17-20 weeks

quickening, lanugo + vernix present, continues primitive respiratory movement.

Fetal: 21-24 weeks

baby has translucent, wrinkled, pink skin. Surfactant may begin, grey area of viability (baby may or may not survive according to if they have lung, heart, and surfactant)

Fetal: 25-28 weeks

alveoli + surfactant production ramp up, eyelids open, develop some subcutaneous fat.

Fetal: 29-32 weeks

testes may descend, more rhythmic breathing movements.

Fetal: 33-36 weeks

Surge of surfactant(baby ready to take on breathing) lanugo disappears, increased fat deposit.

Fetal: 37-40 weeks

Big antibody transfer, vernix disappears well defined ears.

Prenatal Devlopment in Pregnancy Rubin's tasks: Ensuring safe passage

achieve healthy pregnancy + baby, prenatal care, look up to role models, more protective of themselves and taking care of their health

Prenatal Devlopment in Pregnancy Rubin's tasks: Ensuring acceptance of child

ensure acceptance in the significant people in their lives, relationships redefined, creates new mothering/parenting identity that fuses with their existing identity.

Prenatal Devlopment in Pregnancy Rubin's tasks: Binding in

establishment of bond between mother and baby, baby feels like a real person but an independent/seperated person, nesting behaviors.

Prenatal Devlopment in Pregnancy Rubin's tasks: Learning to give of oneself

recognize pregnancy creates physical + lifestyle changes, prepares mother to put baby's needs above their own; help develop their identity as mother/parent.

Influences in Fetal/prenatal Development: Smoking/Tobacco impact

Low birth weight

Influences in Fetal/prenatal Development: alcohol

fetal alcohol spectrum disorder (FASD) no amount is safe during pregnancy due to different physiological things.

Influences in Fetal/prenatal Development: Enviornmental Pollutions

industrial contaminants such as dioxin and PCBs, associated with brain abnormalities + delayed cognition.

Influences in Fetal/prenatal Development: Mercury

cognitive impairments, usually from seafood

Influences in Fetal/prenatal Development: Lead

cognitive impact + preterm birth, (can be from paint)

Influences in Fetal/prenatal Development: Thalidomide

deformities of arms and legs.

Biophysical Influences

-health status of pregnant client

-obstetrical history

-microbiome

-nutrition/activity

-age

Psychosocial Influences

-adverse or diverse lifestyles: someone might be using substance during pregnancy, or LGBTQ+ community

-mental health

-emotional distress/prenatal distress

-disturbed interpersonal relationships; partner violence tend to increase its frequency + severity during pregnancy

Sociodemographic Influences

-lack of prenatal care

-lack of insurance or providers

-low income

-lack of support

-racial/ethnic disparities

Enviornmental Influences

-things individuals are exposed to:

-food deserts

-hazards in home, community, workplace

Stages of Labor: 1st stage

regular contractions, cervix dilate 10cm

Stages of Labor: 2nd stage

cervix fully dilated, pushing of baby

Stages of Labor: 3rd stage

birth of infant, delivery of placenta

Stages of Labor: 4th stage

bonding + attachment, recovery

Baby's Adaptation to extrauterine life

-establish respiration (most important) independent circulation and oxygenation from bay's own respiratory efforts.

-thermoregulation (next important)

-neonatal circulation

APGAR score:

given 1-5 minutes after birth, 5 components

-heart rate

-respiratory rate

-muscle tone

-reflex irritability

-color

APGAR Scores meaning

-0-3: severe distress

-4-6: moderate distress

-7-10: minimal or no distress( no difficulty adjusting to extrauterine environment/life)

Transition to Motherhood/Parenthood: Taking in phase

-need rest; recover from labor + birth

-dependent behavior: nurse help patient with daily activities.

Transition to Motherhood/Parenthood: Taking hold phase

-initiate their own care

-still require support, education, and reassurance.

Transition to Motherhood/Parenthood: Letting go phase

-get more confident

-embrace new role as parent

Baby blues vs. postpartum depression

-baby blues: resolves after 10-14 days after delivery, mild depression occurring first few days of delivery.

-postpartum depression: last longer, severe symptoms, feelings of hopelessness + despair, not taking care of themselves or the baby

Family adaption: Bonding

strong emotional tie between parents and newborn

Family adaption: Attachment

tie occur over time as result of parent-newborn interaction.

Reflexes: Moro reflex

-startle reflex, baby spread out and pull arms in, in response to loud noise or loss of support

-purpose: help baby cling to mother if loss of balance.

-Disappears in about 3 months

Reflexes: Tonic neck

-if head is turned to one side, they will extend their arm and leg on that side.

-purpose: help infant visualizes their own hand + eye coordination

-disappear in about 5 months.

Reflexes: Rooting

-Turning their head toward anything that strikes their cheek or mouth, searching for the object by moving their head back and forth.

-purpose: assist in feeding + breastfeeding

-disappears in about 4 months

Reflexes: Sucking

-sucking movements when anything touches lip or mouth.

-purpose: feeding

-disappears in about 6 months

Reflexes: Babinski

-elicited by firm stimulus on the sole of their foot, dorsification of their great toe + fan their smaller toes.

-purpose: test of higher neurological function

-should disappear in about 3 months (if not= indicate neurological damage)

Reflexes: Grasp

-place object in infants' hand and stroke their palm, finger swill close

-purpose: explore world around them

-disappears about 3 months

Reflexes: Stepping

-when soles of feet touch flat surface, they will attempt to walk by placing one foot in front of the other.

-purpose: prepare infant for walking

-disappear in about 4 months

Preterm

Describes length of gestation, regardless of weight of infant

Low-birth weight

less than 2,500 grams or below expected weight for gestational age.

States of arousal: Regular sleep

little to no body movement, no eye movement, relaxed face, regular slow breathing

States of arousal: Irregular sleep

random limb movements, rapid eye movements, stirring, facial activity, irregular breathing.

States of arousal: Drowsiness

either falling asleep or waking up, some body movements, drowsy eyes, irregular breathing

States of arousal: Quiet alert

body relatively inactive, eyes open/attentive, regular breathing

States of arousal: Waking activity and crying

frequent burst of activity(no purpose in their movements), face may be relaxed or tense, may cry, irregular breathing.