05.03 Fetal Environment

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Overview

  1. Important structures form the optimal fetal environment
    1. Amnion
    2. Chorion
    3. Amniotic Fluid
    4. Placenta

Nursing Points

General

  1. Drugs, nutrients, ETOH, viruses, and antibodies can pass through placenta
  2. Larger particles, like bacteria, cannot pass through placenta
  3. Amniotic sac and mucus plug act as a barrier to keep toxins from passing through the cervix

Assessment

  1. Amnion
    1. Inner membrane that forms the amniotic sac that later surrounds the embryo/fetus
  2. Chorion
    1. Outer membrane that forms the fetal side of the placenta
    2. Eventually develops vascular structures
    3. Forms placenta
  3. Amniotic fluid
    1. Cushions, protects, temperature control
    2. Fetus will swallow amniotic fluid, urinate it out, and move it through their respiratory system
      1. Doesn’t provide nutrients
  4. Placenta
    1. Fully formed at 10 weeks and at 12 weeks produces hormones
    2. It’s an organ!
    3. Provides gas exchange, exchange of nutrients and waste products between mom and baby

Therapeutic Management

  1. Management will revolve around ensuring the environment is safe for fetal development
    1. No alcohol, illegal drugs, or medications that are unsafe in pregnancy
    2. Healthy diet
    3. Hydration
  2. Making sure proper development of the fetal environment occurs or it will not be viable

Nursing Concepts

  1. Reproduction
  2. Human development

Patient Education

  1. Safe medications
  2. No alcohol
  3. Prenatal vitamins

Reference Links

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Video Transcript

In this lesson I will explain the effects of the environment on the fetus and your role in helping to create a safe environment.

The fetal environment is crucial for fetal development. The fetal environment is composed of the amnion, chorion amniotic fluid, and placenta. So let’s just first review that for all of this environment to develop implantation has occurred. The blastocyst has implanted into the endometrium. So from this the amnion and chorion will form. The amnion will form from the Inner membrane of this will develop into the amniotic sac that will later surrounds the embryo/fetus. The chorio is the outer membrane and this will form the fetal side of the placenta. The chorion develops vascular structures that form chorionic villi and forms placenta. These chorionic villi think of them as finger like projections that really grab hold and maximize contact with maternal blood. This will help increase the ability to get nutrients to the fetus from the maternal blood. Amniotic fluid is the next component of the fetal environment. Fluid fills the sac mostly from maternal fluids but then further into the pregnancy the fetus swallows the fluid and voids and the amniotic fluid becomes composed of fetal urine. The amniotic fluid is provides cushion, protection, temperature control and supports fetal development. So let’s look at each of these. Its a cushion because its a bag of water so this offers support as the mother is moving around. It provides protection because it is a barrier. It is sealed so nothing can get in. Think of a water balloon. Nothing can get in or out until it pops. It helps with fetal development in so many ways. The fetus can move around and this helps with muscle development and growth. The fetus will do practice breaths with the amniotic fluid to develop the lungs. This will also provide a stable temperature environment for the fetus because it regulates its own temperature. Last is the placenta. So remember the placenta forms from the chorion. The placenta will be fully formed at 10 weeks and at 12 weeks it takes over hormone production. The placenta is an organ! It will provides gas exchange, exchange of nutrients and waste products between mom and baby.
Now that the fetal environment is developed let’s look at different things that might be able to invade the safe environment. So drugs, alcohol, and viruses and antibodies can cross the placenta. So of those antibodies can help the fetus in the environment but drugs, alcohol and viruses could cause harm. Bacteria is a larger particle so it cannot pass through placenta. Barriers are so important for protection. So again the amniotic sac is sealed and will keep things out. There is also a mucus plug that acts as a barrier to keep toxins from passing through the cervix Think of this as a cork So you have the uterus that is filled with the amniotic sac and there is a cork which is an extra barrier to keep things out. So in this image at the base of the uterus in the cervix is where the plug is located.
Our management and education aren’t going to be too much at this time. The patient usually is not even aware that she is pregnancy yet. So management will revolve around ensuring the environment is safe for fetal development. Make sure the mother is not consuming alcohol or using illegal drugs or medications that could cross the placenta and be harmful. We also need to make sure proper development of the fetal environment occurs .If this environment doesn’t develop properly then it will not be viable.
Education needs to revolve around ensuring they are taking prenatal vitamins and that there is no drinking alcohol as well as that medications they are taking are safe. It is also good to ensure they have a list of safe over the counter medications that they can take during pregnancy.

Our nursing concepts for this patient are reproduction and human development because reproduction has occurred and this environment is necessary for human development.
Ok so our key points to bring it all together are that the amnion, chorion, amniotic fluid, and placenta are part of the fetal environment. The amnion is going to form the outer membrane and enclose the embryo making the embryonic sac. The chorion is going to develop into the placenta from the inner membrane. The amniotic fluid is going to provide a barrier, a cushion, temperature control, and support fetal growth and development. The placenta is an organ! At 12 weeks it will produce hormones and it provides the gas exchange and nutrients to the fetus. So now the the things that can cross the placenta and cause harm. Alcohol, drugs, viruses can all cross. These are legal and illegal drugs. Some medications are safe and some are not.

Make sure you check out the resources attached to this lesson and review how all these pieces of the environment play a vital role in fetal development. Now, go out and be your best selves today. And, as always, happy nursing.

Read more

  • Question 1 of 5

A 16-week pregnant patient asks the nurse what the placenta is for? Which of the following should be included in the nurse’s response? Select all that apply.

  • Question 2 of 5

A nurse is educating a pregnant client on fetal circulation. The client wonders how the baby gets oxygen if the lungs aren’t working properly. The correct response by the nurse is that gas exchange occurs where?

  • Question 3 of 5

A nurse is educating a pregnant client on the role of amniotic fluid. Which of the following should be included in the teaching? Select all that apply.

  • Question 4 of 5

A nurse is helping a nursing student review the development of the fetal environment. The nursing student would be correct in identifying that which of the following structures develops from the chorion?

  • Question 5 of 5

A nurse is providing prenatal instructions to a newly pregnant client. The client asks if it is safe to continue taking her medications. The nurse’s response is based on the knowledge that:

Module 0 – OB Course Introduction

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