Nursing Care During Normal Pregnancy and Fetal Development

100 question-and-answer flashcards covering key concepts from the NCM 107 lecture on normal pregnancy and fetal development.

What is the first step of the nursing process?

Assessment

Which two assessment measures are routinely used to monitor fetal growth?

Fundal height and fetal heart rate

Define a teratogen.

Any substance that can harm a fetus and interfere with normal development

Name the three stages of prenatal development.

Pre-embryonic, embryonic, and fetal stages

Where does fertilization most commonly occur?

In the ampullar (outer third) portion of a fallopian tube

How long after ovulation is an ovum capable of being fertilized?

About 24 hours

What is the functional life span of spermatozoa in the female tract?

Approximately 5 days

What structure forms when the chromosomes of sperm and ovum fuse?

A zygote

State the three factors necessary for successful fertilization.

Mature sperm and ovum, sperm reaching the ovum, and sperm penetrating the zona pellucida

Implantation normally occurs how many days after fertilization?

Approximately 8–10 days

Which outer cell layer of the early conceptus later becomes the placenta?

Trophoblast

Which hormone keeps the corpus luteum functioning after fertilization?

Human chorionic gonadotropin (hCG)

What name is given to the endometrium once implantation has occurred?

Decidua

What is the first placental hormone to appear in maternal blood?

hCG

What is the chief role of progesterone during pregnancy?

Maintaining the uterine endometrial lining

Which placental hormone has both growth-promoting and lactogenic properties?

Human placental lactogen (hPL)

Define hydramnios.

Excessive amniotic fluid (more than 2,000 mL or pockets >8 cm on ultrasound)

Define oligohydramnios.

Too little amniotic fluid (less than 300 mL or no pocket >1 cm)

How many vessels are normally present in the umbilical cord?

One vein and two arteries (three vessels total)

What is the average umbilical cord length at term?

About 53 cm (21 inches)

What are totipotent stem cells?

Early cells (first 4 days) able to become any cell type in the body

Which primary germ layer forms the body’s exoskeleton and skin?

Ectoderm

Which germ layer develops into most body organs?

Mesoderm

Why is maternal rubella infection serious in pregnancy?

The virus can infect all three germ layers, causing multiple congenital anomalies

By what day does the fetal heart tube begin to beat?

Around day 24 of pregnancy

Fetal heart tones can be heard with Doppler starting at which week?

10–12 weeks

What is the typical fetal heart rate after 28 weeks?

About 110–160 beats per minute

Which fetal vessel allows oxygenated blood to bypass the liver?

Ductus venosus

What fetal opening permits blood flow from right atrium to left atrium?

Foramen ovale

How does fetal hemoglobin differ from adult hemoglobin?

It contains two alpha and two gamma chains instead of two beta chains

Why does fetal hemoglobin bind oxygen more strongly than adult hemoglobin?

It is more concentrated and has higher oxygen affinity to ensure adequate fetal oxygenation

What is the approximate newborn hemoglobin level at birth?

About 17.1 g/100 mL of blood

At approximately which week does pulmonary surfactant production begin?

Around the 24th gestational week

Name the two main phospholipid components of surfactant.

Lecithin and sphingomyelin

Which lecithin-to-sphingomyelin (L:S) ratio indicates mature fetal lungs?

A ratio of 2 : 1

By which week is the diaphragm fully formed?

Seventh gestational week

Failure of diaphragmatic closure can lead to what defect?

Congenital diaphragmatic hernia

By which week are fetal brain waves detectable on EEG?

By the 8th week

Deficiency of which nutrient increases risk for meningoceles?

Folic acid

Which fetal organ produces insulin?

The fetal pancreas

By what week is fetal urine excreted into amniotic fluid?

16th gestational week

When does the mother typically first perceive fetal movement (quickening)?

Between 16 and 20 weeks

During which weeks do the testes usually descend into the scrotum?

34th to 38th weeks of gestation

What is the purpose of lanugo on the fetal skin?

Provides insulation and helps preserve warmth in utero

When do maternal IgG antibodies begin crossing the placenta?

As early as 20 weeks, certainly by 24 weeks

Explain Naegele’s rule for estimating date of birth.

Count back 3 months from first day of last menstrual period and add 7 days

Where is the uterine fundus located at 20 weeks of gestation?

Level with the umbilicus

Describe McDonald’s rule.

From weeks 20–31, fundal height in centimeters equals gestational age in weeks

At what point should a woman call her provider based on daily kick counts?

If fewer than 10 movements are felt within two consecutive hours

What result defines a reactive nonstress test?

At least two accelerations of 15 bpm lasting 15 seconds within 20 minutes

What is the purpose of vibroacoustic stimulation during fetal testing?

To startle and awaken the fetus so movement and heart rate can be assessed

Give one early-pregnancy use of ultrasonography.

To confirm and date a pregnancy as early as 6 weeks gestation

A biparietal diameter of 8.5 cm usually predicts what?

Fetal age of about 40 weeks or birth weight over 2,500 g

What does a grade 3 placenta on ultrasound usually signify?

Placental and likely fetal lung maturity at about 38 weeks

What condition is screened by measuring nuchal translucency?

Chromosomal anomalies such as Down syndrome

List the five parameters of a biophysical profile.

Fetal reactivity, breathing movements, body movement, tone, and amniotic fluid volume

Maternal serum AFP primarily screens for which fetal problem?

Neural tube defects

Low maternal PAPP-A levels are linked to what fetal issues?

Chromosomal anomalies and small-for-gestational-age infants

Chorionic villus sampling is usually performed during which weeks?

10–12 weeks gestation

What does amniocentesis involve?

Aspiration and analysis of amniotic fluid from the uterus

Define percutaneous umbilical blood sampling (PUBS).

Aspiration of fetal blood from the umbilical vein for analysis

What is lightening in late pregnancy?

Descent of the fetus into the pelvis, giving a sense of lighter load

Approximate embryo length at the end of the 4th week?

About 0.75 cm

By which week is organogenesis complete?

End of the 8th week

At what week is sex distinguishable by external appearance?

End of the 12th gestational week

By which week is lanugo well formed?

End of the 16th week

When does the fetus become capable of producing its own antibodies?

End of the 20th gestational week

What gestational age marks the lower limit of viability in modern NICUs?

Approximately 24 weeks (500–600 g)

At which week does significant subcutaneous fat start to deposit?

Around 32 weeks

Most fetuses assume a vertex position by which week?

36 weeks

Average fetal weight at 40 weeks?

About 3,000 g (7–7.5 lb)

Fundal height far above expected norms may indicate what?

Multiple gestation, incorrect dates, LGA infant, hydramnios, or trophoblastic disease

Where is the fundus typically found at 12 weeks?

Just above the symphysis pubis

Why is the woman placed in semi-Fowler’s position during rhythm-strip testing?

To prevent vena cava compression and supine hypotension

What is considered a normal baseline fetal heart rate?

110–160 beats per minute

Define absent variability on fetal heart monitoring.

No detectable peak-to-trough changes in heart rate

Which hormone is detected by standard home pregnancy tests?

hCG

What is the approximate uteroplacental blood flow at term?

500–600 mL per minute

Hypercoiled umbilical cords are associated with what neonatal issue?

Respiratory distress in the newborn

What components make up meconium?

Cellular wastes, bile, fats, mucoproteins, mucopolysaccharides, and vernix caseosa

What is brown fat and when does it begin to form?

Special heat-producing fat, appearing around the 20th week behind kidneys and neck

How many lunar months does a full pregnancy last?

10 lunar months (40 weeks)

Why is the uterine lining called the decidua in pregnancy?

Because it will be shed after the birth

Which two membranes form the amniotic sac?

Chorion (outer) and amnion (inner)

How does amniotic fluid aid lung development?

Fetus breathes fluid in and out, mixing with surfactant and expanding airways

Typical volume of amniotic fluid at term?

About 800–1,200 mL

Which structure connects the embryo to the chorionic villi?

Umbilical cord

Umbilical cord hypocoiling is linked to what maternal condition?

Maternal hypertension

Which four serum markers are measured in a quadruple screen?

AFP, hCG, unconjugated estriol, and inhibin A

Fetoscopy can directly confirm the intactness of which fetal structure?

The fetal spinal column

When do spontaneous fetal respiratory practice movements start?

As early as 3 months gestation

At what week do eyelids open and pupils begin reacting to light?

End of the 24th week

What does cephalocaudal growth mean?

Development proceeds from head toward the tail/feet

During early pregnancy, which ultrasound measurement predicts gestational age?

Crown-to-rump length

What maternal position enhances accurate daily kick counts?

Left lateral (left recumbent) position after a meal

What fetal condition is associated with maternal smoking?

Fetal tobacco syndrome

Which hormone stimulates uterine growth and breast development?

Estrogen

Bone ossification from cartilage begins at roughly which week?

Around the 12th gestational week

Define a blastocyst.

Early embryonic structure with inner cell mass (embryoblast), outer trophoblast, and fluid cavity

What is the purpose of Doppler umbilical velocimetry?

To measure velocity of blood flow in uterine and fetal vessels