Chapter 8 The Developing Person: Prenatal and other Developmental Influences - PowerPoint Presentation

1. Chapter 8The Developing Person: Prenatal and other Developmental Influences

2. The Beginning

3. ConceptionFemale ovulatesMale releases at least 20 million spermOnly a fraction reach the fallopian tubesMany penetrate the ovumOnly one fertilizes the ovumOccurs approximately 14 days after beginning of menstrual cycleIn outer 1/3 of fallopian tubeCalled a zygote

4. Multiple Births Fraternal twins two eggs fertilized by two sperm- two separate sacs/babiesIdentical twins one egg fertilized by one sperm that divides into two separate babies after fertilization – one sac/two babies

5. Stages of Prenatal DevelopmentGerminal Stage10 days to 2 weeks post fertilizationRapid cell division and increasing complexityImplantation into the uterine wallPlacentaUmbilical cordTwo arteriesOne veinAmniotic sacEmbryonic stage2 weeks to 8 weeksRapid growth and differentiation of major body systemsNeural tube forms spinal cord (21 days)Heart functions (22 days)Brain formed (26-27 days)Paddle hands (32 days)All internal/external structures present (50 days)Embryonic stage

6. Stages of Prenatal DevelopmentFetal Stage8 weeks to birthOva formed in female, sex determination is possible (13-16 weeks)Quickening (13-16 weeks)Store fat and minerals, testes descend in males (29-32 weeks)http://www.youtube.com/watch?v=RS1ti23SUSw

7. Prenatal Influences on Development

8. HeredityEveryone has some abnormal genesNot all will cause problemsCongenital malformationsPhysical/mental problems that occur before birthGenetic – dominant or recessive genesFragile X- female carrier, male demonstrates problemsRecessive – cystic fibrosis, sickle-cell, muscular dystrophyNon-inheritedDown Syndrome – three copies of chromosome 21Not fully determined by heredity, environment plays a factor in IF the traits develop

9. Parental AgeAge of the mother and father, and the number of previous pregnancies affect the health of the fetusTeen years/poverty – associated with low birth weight, neurologic defects, higher mortality rates, and more developmental problemsThree or more pregnancies BEFORE age 20 is less likely to be healthyAFTER age 35 increases risk of delivery complications, low birth weight, Down Syndrome, faternal twinning is commonMales over age 40 creates more opportunities for errors in sperm creation- Down syndrome, dwarfism, Marfan syndrome, bone malformations

10. Prenatal Endocrine and Metabolic FunctionPlacenta provides estrogens, progesterone and gonadotropin to sustain pregnancyFirst critical period for sexual differentiation Needs corresponding hormones during pregnancy to develop properlySecond critical period just prior to birthSex typing of the brain may occurMothers metabolic function affects fetus Hyperglycemia- stimulates fetal insulin secretion, a potent growth factor

11. Maternal Nutrition Caloric and protein intake are of particular importance200-300 calories more beginning in second trimesterOverweight female trying to lose weight during pregnancyKetoacidosis associated with neuropsychological defectsBox pg. 221 for full detailsLack of nutrients may causeLow birth weight, prematurity, still birth, congenital malformations, and infant mortalityA link between fetal under-nutrition and schizophrenia has been found8 glasses of water and adequate fiber intakeMore than 8 cups of caffeine daily during pregnancy associated with stillbirthsAvoid seafood during pregnancy due to mercury content

12. Maternal Nutrition continuedWeightGain 2-4 lbs first trimester0.8-1 lb each week thereafterEmphasize importance of prenatal vitaminsAnemiaDecrease in oxygen carrying capacity of bloodSickle cell: Intrauterine growth retardation, premature labor, stillbirthPICACraving and eating nonfood itemsClay, mothballs, petrol, wood, soap, etcInterferes with normal nutrition by reducing appetite and may interfere with absorption of iron, zinc and potassium

13. Maternal Exercise and Physical ActivityModerate exercise does NOT endanger the fetusRegular exercise Prevents constipationImproves respiration/circulationImproves muscle tone and skin elasticityHeart rate BELOW 140 and taper off slowly – not abruptlyStrenuous/stressful work, excess fatigue and long work hours increase risk of premature birth

14. Environmental Hazards to the Fetus

15. Tetratogens Development of abnormal structuresTiming, intensity and duration in development are the most important factorsRadiationChemical wastesContaminated waterHeavy metalsFood additives- hormones or drugs used in foodPollutants- lead, mercury, chemicalsChemicals- dioxin (agent orange and PVC) – spina bifida, cleft lip and neoplasms

16. Tetratogens continuedTobaccoLowered birth weight, reduced sperm counts/shape, increased risk of SIDSMedicationsNo drug should be taken during pregnancy unless medically prescribed as necessaryAbuse/Addictions- DrugsAlcoholFolkloreIf does not interfere with development, do not exclude

17. Fetal AddictionsTwice as likely to die after birth as non-addicted babyMarijuana- low birth weight, premature birth, neurologic disorders, increased risk of cancersCocaine/opiates – vasoconstriction of placental blood flow, spontaneous abortions, placental abruption, postpartum hemorrhageMeth-fetal hypoxia and distress, microencephalyAlcohol – several deformities; ADD, ODD, conduct and mood disordersScreen during pregnancyEducation of affectsAssistance to find support for stopping

18. Fetal Alcohol SyndromeAlcoholseveral deformities- FacialCardiacDecreased brain weightImpaired fine motor skillsADD/ADHD, ODD, conduct and mood disorders

19. Figure 8-2 pg. 224

20. Maternal InfectionsVaginal infections can travel up to the amniotic sac and penetrate the walls infecting the amniotic fluid – syphilis, chlamydia and gonorrhea Viruses (chickenpox, mumps, Hep B) can cause life-threatening fetal infectionsRubella/Rubeola – interferes with fetal blood flow and oxygenation resulting in fetal deathHIV/AIDS- treatment protocols for babies born infectedHerpes – most problematic during delivery, might need C-sectionCMV- congenital mental retardation, despite no symptoms in motherToxoplasmosis – from feces of catsOthers yet known…H1N1….Education about immunizations and precautions during pregnancy

21. Maternal EmotionsAnxiety and fearJob stressPhysical and emotional abuseEffects of maternal emotionsFetal circulatory issuesNutritional processes issuesIntrauterine development issuesPreterm delivery, low birth rateEffects of anxiety may influence:Infant temperamentBehavior problems

22. Childbirth Issues that Affect the BabyMedicationsAnalgesics and sedativesDecrease APGARLess with epidural than IVNatural Childbirth Method (Lamaze)Best as it uses NO drugsInadequate OxygenationDrug induced respiratory depressionApneaKinks in umbilical cordWrapping cord around neckLong laborMalpresentation of fetusLow sensorimotor and cognitive-intellectual functionMental retardationCerebral palsy

23. Childbirth Issues that Affect the BabyPremature birthBirth prior to 37 weeksLow birth weightLess than 5.5 lbs regardless of ageHigh risk of death in first 4 weeks of lifeLater developmental and behavioral problemsHyperactivityVery low weight less than 3.3 lbsLanguage, cognitive, behavioral and social problemsMay be normalExtremely low weight less than 2 lbs

24. Childhood VariablesNutritionDecreased protein can account for 30% of neurons never formingBreast milk food of choiceImmunologic aspectMaternal ingestionGrowth retardation is most obvious sign of altered nutritionStressIllnessHospitalizationAbuse/neglectEmotional deprivationNatural disastersWarDepressionWithdrawalImpulsiveness and acting out

25. Childhood Variables continuedEnvironmentalLeadDrinking water contaminationPesticidesAir pollutionTobaccoAsthmaAllergiesImmune dysfunctionVulnerable and resilient kidsResilienceHealthy personality and effective behavioral outcomes despite serious threats to adaptation or developmentVulnerableClosest emotionally to the distressed parent and are most likely to show signs of distress and later psychiatric disorders

26. Childhood Variables continuedAbusePhysicalassaultEmotionalDestroy self-esteemNeglectFood, shelter, clothingSexualAbandonmentFailure to ThriveUnable to obtain or use calories required for growth – below 5th percentile for ageOrganicCongenital, CF, AIDS, addictionNon-organicPsychosocial – neglect, lack of knowledge

27. Nursing CareDiagnosesRisk for Delayed DevelopmentDelayed growth and developmentRisk for disproportionate growthDeficient knowledgeReadiness for enhanced knowledgeIneffective protectionInterventionsAssess situationProvide educationAssist with setting up support systems