Midterm (Ken).txt

zygote/morula becomes a blastocyst. once fluid begins accumulating in this center cavity. The fluid is a combination of uterine fluids and secretions from the cells themselves. Outer layer of cells form on the blastocyst referred to as the trophblast and replaces the zona pellucida

Zygote attaches itself to the lining of the uterus ( for nourishment). Implantation occurs in the upper portion of the uterus

• ENDODERM; The Innermost layer.; includes; respiratory tract* epithlium of the disgestive tract, bladder, thyroid* primary tissue of the liver and pancreas*
• MESODERM; In between the endoderm and ectoderm;includes; dermis* muscle* bone* connective tissue* lymphnoid tissue* reproductive organs* cardiovascular system
• ECTODERM; outermost layer and the thickest; includes; epidermis*nails*hair* lens of the eye* central and peripheral nervous system* Skin glands

It is during the alveolar period that mature surfactant is produced in increasing amounts by the type II cells. 27 weeks to term

The fetal lung is considered mature when the L/S (lecithin sphingomyelin) ratio is 2:1. This usually occurs around week 35. This also coincides with the onset of mature surfactant production and indicates little chance of developing in RDS

they are well below the level that could cause damage to tissue and are used to locate and visualize organs and tissue

Either a hand-held or transvaginal transducer

by using measurements of crown-rump length, biparietal diameter, abdominal circumference, and femur length

by combining head size, abdominal circumference, and femur length

once fetal age and weight are determined

• normal heart rate 120-160
• bradycardia <100
• tachycardia >180

• -Nagels rule; subtract 3 months from last menstrual period, then add seven days
• -Fundal height; measures distance from the symphysis pubis to the top of the uterine fundus, which is located on opposite end of the cervix. 1cm = 1 week, 20cm = 20 weeks

• - Contraction stress test; stress comes from an interruption of maternal blood to the intervillous spaces during contractions. A positive CST is defined a more than 50% of contractions having late decelerations. No decelerations after any contractions indicate a negative CST
• - The nonstress test; where the heart accelerates to greater than 15BPM for at least 15sec with fetal movement 2 times in a 20min window. Nonreactive NST occurs when the fetal heart rate does not accelerate during fetal body movement over a two 20min periods. A fetus suffering from prolonged hypoxia will have a positve CST with a negative NST. A negative CST results in the presence of a negative NST indicate the problem is one of fetal sleep or maternal narcotic or sedative ingestion

• 1. Nasal flaring
• 2. grunting
• 3. retractions

• INFANT- tongue is proportionally larger than the adult tongue
• INFANT-have a large amount of lymphoid tissue in the larynx
• INFANT EPIGLOTTIS- proportionally larger, less flexible, and is omega-shaped.
• INFANT EPIGLOTTIES - lies more horizontally than the
• narrowest part of the infant airway is the cricoid ring ADULT is the glottis
• INFANT LARYNX lies higher in the neck in relation to the cervical spine
• *ALL THESE FACTORS MAKE THE INFANT AIRWAY MORE SUSCEPTABLE TO OBSTRUCTION*

Ballard gestational age assessment; 6 physical, 6 neurological signs

• Original System:
• Dubowitz gestational age assessment; 11 physical 10 neurological signs

• Physical: skin, lanugo, plantar surface, breast, eye/ear, genitals, genitals female.
• Neurological: posture, square window/wrist, arm recoil, popliteal angle, scarf sign, heel to ear.

• Ultrafiltration
• Simple diffusion
• Facilitated diffusion
• Active transport
• Breaks in the placental villi

through the gastrointestinal tract, intramuscular administration, by topical absorption through the skin and respiratory tract, and through direct intravenous administration.

beta adrenergics

Drug of choice is Ipatropium bromide(atrovent)

deficiency of consistent surfactant production before week 35

• Oxygen toxicity
• Barotrauma
• Presence of PDA
• Fluid overload

high PaO2s

• 1. Hypernatremia
• 2. Shock
• 3. Acidosis
• 4. Blood transfusions
• 5. Seizures
• 6. Rapid Volume Expansion
• 7. Fluctuation in cerebral blood flow

• airway obstruction with hyperinflation
• inflammatory response of the tracheobronchial epithelium to the presence of meconium. This is called chemical pneumonitis

spontaneous abortion, congenital malformations, intrauterine growth retardation, mental retardation, and carcinogenesis

dose the fetus is exposed to, the length of exposure, age of the fetus, other drug interactions

first trimester

• The process by which drugs enter the body(absorption), are distributed throughout the system(distribution), are changed or altered from the original compound(metabolism), and eventually leave the body(excretion)
• "What the body does to the drug"

sympathomimetic