Chapter 3 + 4 Notes!
Chapter 3 + 4 Notes! Nursing 200
Popular in Growth Development and Health
Popular in Nursing and Health Sciences
verified elite notetaker
Sarah Jessica Harris
verified elite notetaker
CLAS 160D2 - 002
verified elite notetaker
CLAS 160D2 - 002
verified elite notetaker
verified elite notetaker
Sarah Jessica Harris
verified elite notetaker
This 13 page Bundle was uploaded by Becca LeBoeuf on Tuesday February 9, 2016. The Bundle belongs to Nursing 200 at University of Wisconsin - Oshkosh taught by K. Meine in Spring 2016. Since its upload, it has received 22 views. For similar materials see Growth Development and Health in Nursing and Health Sciences at University of Wisconsin - Oshkosh.
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Date Created: 02/09/16
Heredity and Environment: ● What Genes Are: ○ DNA (deoxyribonucleic acid): olecule that contains the chemical instructions for cells to manufacture various proteins. DNA promotes growth and sustains life. ○ Chromosomes: molecules of DNA. Consists of 46 chromosomes arranged in 23 pairs. ○ Protein: contains sequence of chemicals consisting of long strings of amino acids. Consists of instructions for stringing together the right amino acids in the right order via pairs of four chemicals called bases (TAGC). ○ Allele variation of a gene or any of the possible forms in which a gene for a particular trait can occur. Effects of variations vary greatly from causing lifethreatening conditions to having no detectable effect at all. ○ Genetic diversity:distinguishes each person. Allows the human species to adapt to pressures of the environment. ○ Methylation:processes additional DNA and RNA that enhances, transcribes, connects, and alters genes. ○ Genome: involves the full set of genes that are instructions to make an individual member of a certain species. ○ How proteins are made: ■ A cell contains a nucleus. ■ In this nucleus, there are 23 pairs of chromosomes. ■ Each chromosome contains genes. ■ This creates a DNA molecule with (TAGC). ○ Genotype: an organism’s genetic inheritance, or genetic potential. ● The Beginnings of Life: ○ Zygote: two gametes (sperm and ovum) combine and produce a new individual with 23 chromosomes from each parent. ○ Gametes: reproductive cells (sperm and ova). Each gamete consists of 23 chromosomes. ○ Females: XX. ○ Males: XY. ○ The zygote begins duplication and division then differentiation and specialization occur. ■ Duplication: ■ Division: ■ Differentiation: ■ Specialization: ● Siblings and Twins: ○ Monozygotic (identical) twinoriginate from one zygote that splits apart very early in development. When splitting does not happen, conjoined twins occur. They have the same genotype but slight variations in phenotype (can possibly be due to environmental influences). ○ Dizygotic (fraternal) twiesult from fertilization of two separate ova by two separate sperm. Dizygotic twins have half their genes in common and occur twice as often as monozygotic twins. Twins who are of different sexes or who have obvious differences in personality are dizygotic. Many samesex twins with similar looks and temperaments are dizygotic. ● Assisted Reproduction: ○ Assisted reproductive technology (ART)eneral term for the techniques designed to help infertile couples conceive and sustain a pregnancy. ○ In Vitro Fertilization : involves fertilization that takes place outside a woman’s body. Involves mixing sperm with surgically removed from the woman’s ovary and implanting zygote into a woman’s uterus. ● From Genotype to Phenotype: ○ Phenotype: observable characteristics of an organism, including appearance, personality, intelligence, and all other traits. ○ Polygenic: trait is influenced by many genes. ○ Multifactori: trait affected by many factors, both genetic and environmental. that enhance, halt, shape, or alter the expression of genes, resulting in a phenotype that may differ markedly from the genotype. ● Epigenetics: refers to environmental factors that affect genes and genetic expression. ● Gene To Gene Interactions: ○ Human Genome Project: involves international effort to map the complete human genetic code. ■ Was essentially completed in 2001, though analysis was ongoing. ○ Some Interesting Findings: ■ Humans have far fewer genes than previously believed. ■ All living creatures share many genes. ● Additive Heredity: ○ Additive Genes genes add up to make the phenotype. ○ Example: Height is affected by the contributions of about 100 genes. ● Gene To Gene Heredity: ○ Dominantrecessive heredit dominant gene is far more influential than the recessive gene (nonadditive). ○ Dominant gene can completely control the phenotype with no noticeable effect of recessive gene. ○ Effect of recessive genes can sometimes be noticed. ● DominantRecessive Heredity: ○ Carrier: person whose genotype includes a gene that is not expressed in the phenotype. ■ Unexpressed gene occurs in half of the carrier’s gametes and is passed on to half of the carrier’s offspring. ■ Offspring can be carrier or express the gene in the phenotype (ex: when unexpressed gene is inherited by both parents). ● Xlinked a gene carried on the x chromosome. ● More Complications: ○ Copy number variations: ■ Occur in abundance. ■ Involve genes with various repeats or detections of base pairs. ■ May be inconsequential, lethal, or something in between. ○ Parental imprinting: ■ Occurs when genes from either mother or father are affected. ■ May differ for XX versus XY embryos. ■ Syndrome example: PraderWilli syndrome and Angelman syndrome. ● Genotype and Phenotype: ○ Current consensus: ■ Genes affect every aspect of behavior. ■ Most environmental influences on children raised in the same home are not shared. ■ Gene elicit responses that shape development. ■ Lifelong, people choose friends and environments that encourage their genetic predispositions. ■ Shyness is inherited. ● Alcoholism: ○ Genes create addictive pull. ○ Alcoholism is polygenic and culture is pivotal. ● Risk: ○ Biological sex. ○ Gender. ○ Contexts. ○ Ethnicity. ● Alcoholism: an addiction to the consumption of alcohol liquor or the mental illness and compulsive behavior resulting from alcohol dependency: ○ Alcoholism probably has a genetic basis: ■ Genes can cause an overpowering addictive pull in some people. ■ Environmental conditions can modify the genetic effects. ■ Nature and nurture combine to create an alcoholic. ● Genotype and Phenotypes: Genotype: the genetic constitution of an individual’s organism. Phenotype: the set of observable characteristics of an individual resulting from the interaction of its genotype with the environment: ○ Nearsightedness: ■ Age: Limited focus at birth; change in eyeball shape at puberty; myotopia at middle age. ■ Genes: Alleles of Pax6 contribute to nearsighted. ■ Heritability: Heritability of 90%. ○ Other causes: ■ Evironment. ■ Homework and lack of play. ● Heritabilit: ○ Statistical term that indicates what portion of the variation in a particular trait within a particular population is inherited. ■ Example: 90% of the height differences among children of the same age is genetic. ○ Environment can affect the expression of inherited genes. ● Chromosomal and Genetic Problems: ○ Not exactly 46: ■ Some gametes have more or fewer than 23 chromosomes. ■ Sometimes only part of the 23rd chromosome missing. ○ Down syndrome: ■ Called trisomy21 because the person has three copies of chromosome 21. ■ Involves around 300 distinct characteristics from third chromosome; unique individuals. ○ Why study conditions caused by extra chromosome or single destructive gene? ■ They provide insight into the complexities of nature and nurture. ■ Knowing their origins helps limit their effects. ■ Information combats prejudice: difference is not always deficit. ● Gene Disorders: genetic problem caused by one or more abnormalities in the genome: ○ DominantGene Disorders: ■ Half of the offspring of parents with a dominant disorder will have the disorder. ■ Most dominant disorders begin in adulthood (fatal dominant childhood conditions cannot be passed on). ■ Many dominant disorders have relatively mild or variable symptoms. ■ Tourette Syndrome: ● Some who inherit the dominant gene exhibit uncontrollable tics and explosive outbursts. ● Most have milder, barely noticeable symptoms. ○ RecessiveGene Disorders: ■ Fragile X Syndrome: ● Most common form of inherited mental retardation. ● Additional symptoms include muscle weakness, shyness, and poor social skills. ■ SickleCell Trait: ● Offers some protection against malaria. ● African carriers are more likely than noncarriers to survive. ● Genetic Counseling and Testing: ○ Phenylketonuria (PKU): ■ Recessive condition. ■ Results in inability to metabolize phenylalanine (amino acid found in many foods). ■ Buildup of phenylalanine causes brain damage, progressive mental retardation, and other symptoms. ■ Early testing and a special diet usually results in normal development. ○ Genetic Counseling: ■ Consultation and testing by trained professionals. ■ Enables prospective parents to learn about their genetic heritage, including harmful conditions that may be passed on to their offspring. ○ Ethical Guidelines: ■ Test result are kept confidential. ■ Decisions regarding sterilization, adoption, abortion, or carrying a pregnancy to term are made by the clients. Prenatal Development And Birth: ● Prenatal Growth: ○ Three MAIN Period Of Prenatal Development: ■ Germinal Period (1st two weeks after conception): rapid cell division and beginning of cell differentiation. ■ Embryonic Period (3rd through 8th week): basic forms of all body structures develop. ■ Fetal Period (9th week until birth): fetus grows in size and matures in functioning. ○ Can you define these terms? ■ Beginning of pregnancy. ■ Length of pregnancy. ■ Trimesters. ■ Due date. ● First Stages Of The Germinal Period: ○ The original zygote as it divides into (a) two cells, (b) four cells, and © eight cells. ○ Occasionally at this early stage, the cells separate completely, forming the beginning of monozygotic twins, quadruplets, or octuplets. ● Germinal Period First 14 Days: ○ Zygote begins duplication and division (first the 23 pairs of chromosomes duplicate, forming two complete sets of the genetic code for that person. Then the two sets move towards opposite sides of the zygote and the single cell within the zygote splits nearly down the middle. The zygote’s outer membrane now surrounds two cells, each containing a complete set of the original genetic code. These two cells duplicate and divide to become four, then the four do the same to become eight, and so on) within hours of conception. ■ Development of the placenta. ■ Implantation (about 10 days after conception). ■ Organism grows rapidly. ○ The Most Dangerous Journey: ■ In the first 10 days after conception, the organism does not increase in size because it is not yet nourished by the mother. ● The Embryonic Period From The Third Through Eighth Week: ○ Embryo: ■ Primitive streak becomes the neural tube and later forms the brain and spine of the CNS. ■ Head takes shape. ■ Eyes, ears, nose, and mouth form. ■ Heart begins to pulsate. ■ Extremities develop and webbed fingers and toes separate. ● The Fetal Period: ○ Fetus: ■ 9th week after conception until birth. ■ Genitals form and sex hormones cause differences in brain organization. ■ Cephalocaudal and roximodistal growth. ■ Heartbeat detectable via stethoscope. ■ Cortex is not fully mature at birth. ■ Brain at birth is biggest part of baby. ● Fetus: From Ninth Week Until Birth: ○ The third month: ■ Rapid growth with considerable variation. ■ Average: 3 months; 3 ounces + 3 inches. ■ 9th week: SRY gene triggers development of sex organs. ■ 3rd month: Neurological sex differences begin. ● Fetus: The Middle Three Months: ○ Middle three months: ■ Digestive and excretory system develop. ■ Fingernails, toenails, and buds for teeth form, and hair grows (including eyelashes). ○ Brain: ■ Experiences rapid growth. ■ Follows proximodistal sequence from brainstem, to midbrain, to cortex. ■ Develops many new neurons (neurogenesis) and synapses (synaptogenesis). ■ Begins to regulate basic bodily functions as entire CNS becomes responsive. ● Fetus: The Final Three Months: ○ Last three months: ■ Involves expansion and contraction of lungs. ■ Includes final maturation of heart valves, arteries, and veins. ■ Provides time for extensive growth and folding in cortex. ■ One of the smallest babies ever conceived was from Rumaisa Rahman. Was born after 26 weeks and 6 days weighing at only 8.6 ounces. ● Birt: ○ Fetal brain signals the release of hormones to trigger the female’s uterine muscles: ○ Labor begins: ■ Average duration for firstborn babies: 12 hours. ■ Quicker labor for laterborn babies. ○ Birthing positions vary: ■ Sitting, squatting, lying down, water births. ■ Cultural and personal preference. ■ Choice, culture, cohort? ● The Newborn’s First Minutes: ○ Newborns: ■ Usually cry spontaneously. ■ Color changes from bluish to pinkish. ■ Eyes open, fingers grab, toes stretch, ○ Apgar scale: ■ Quick assessment of newborn’s heart rate, breathing, muscle tone, color, and reflexes. ■ Completed twice (1 minute and 5 minutes after birth). ■ Score of 0, 1, or 2 in each category. ■ Desired score: 7 or above. ● Medical Assistance: ○ Characteristics of childbirth depend on several variables: ■ Parents’ preparation. ■ Position and size of fetus. ■ Customs of culture. ○ In most developed nations: ■ Sterile procedures. ■ Electronic monitoring. ■ Drugs to dull pain or speed contractions. ○ Surgery Epidural: an anesthetic introduced into the space around the dura mater of the spinal cord. ■ Injection in particular part of spine to alleviate pain. ■ Often used in hospital births. ■ Increase rate of cesarean sections and decrease the readiness of newborn infants to nurse. ○ Surgery Induced labor: procedure used to stimulate uterine contractions during pregnancy before labor begins on its own. When successful, leads to vaginal birth. ■ Drugs used to start, speed, or strength labor. ■ Increase rate; now used in about 20% of U.S. births. ○ Surgery Cesareans: a surgical operation for delivering a child by cutting through the wall of the mother’s abdomen. ■ Are controversial. ■ Involve surgical birth. ■ Vary by rates and reasons for use. ■ Present advantages for hospitals; more complications after birth (pelvic organ prolapse). ■ Rates of cesarean sections vary by country. Some are higher than others. India is one of the lowest. Brazil is one of the highest. ● Alternatives To Hospital Technology: ○ Home births. ○ Doula: ■ Woman who helps with labor, delivery, breastfeeding, and newborn care. ■ May be related to the lower rate of cesarean sections. ● Problems And Solutions: ○ Harmful substances: ■ Prenatal teratogens: ● Any agent or condition, including viruses and drugs, resulting in birth defects or complications. ■ Behavioral teratogens: ● Agents and conditions that can harm the prenatal brain, impairing the future child’s intellectual and emotional functioning. ● Risk Analysis Factors: ○ Risk analysis discerns which chances are worth taking and how risks are minimized: ■ Critical time. ■ Dose and/or frequency of exposure (threshold effect). ■ Innate vulnerability. ○ How much is too much? ■ Threshold effect: ● Certain teratogens are relatively harmless until exposure reaches a certain level. ● Thresholds are controversial. ■ Example: Alcohol consumption: ● Embryo exposed to heavy drinking can develoetal alcohol syndrome (FAS). ● FAS: a congenital syndrome caused by excessive consumption of alcohol by the mother during pregnancy, characterized by retardation of mental development and of physical growth, particularly of the skull and face of the infant. ● FAS is more apparent when women are poorly nourished and cigarette smokers. ■ Genetic vulnerability: ● Some zygotes carry genes that make them vulnerable. ● Males fetuses are more vulnerable to teratogens than female ones. ● Mother’s genes affect the prenatal environment she provides. ● Neuraltube defects are more common in certain ethnic groups. ● Before Pregnancy What You SHOULD Do: ○ Plan the pregnancy. ○ Take a daily multivitamin with folic acids. ○ Avoid bingedrinking. ○ Update immunizations against all teratogenic viruses, especially rubella. ○ Gain or lose weight, as appropriate. ○ Reassess use of prescription drugs. ○ Develop daily exercise habits. ● What People REALLY Do: ○ At least a third of all pregnancies are not intended. ○ About 60% of women aged 1845 do not take multivitamins. ○ One in seven women in their childbearing years bingedrink. ○ Unlike in many developing nations, relatively few pregnant women in the U.S. lack basic immunizations. ○ About a third of all U.S. women of childbearing age are obese, and about 5% are underweight. Both extremes increase complications. ○ 90% of pregnant women take prescription drugs (not counting vitamins). ● Applying The Research: ○ Advice from Doctors: ■ Problems: ● Provision of potentially dangerous prescriptions for pregnant women. ● Failure to take time to understand women's life patterns. ○ Advice from Scientists: ■ Problems: ● Provision of contradictory interpretation of research that led to opposite message. ● Prenatal Diagnosis: ○ Early care protects fetal growth, makes birth easier, and renders parents better able to cope. ○ When complications arise, early recognition increases the chance of a healthy birth. ○ About 20% of early pregnancy test raise anxiety instead of reducing it. ● Low Birthweight And The Mother: ○ Maternal behavior: ■ Maternal health and illness. ■ Maternal drug use before and during pregnancy. ○ Maternal malnutrition: ■ Fathers and others. ■ Father attitudes and behaviors. ■ Hispanic paradox (finding that Hispanic and Latino Americans tend to have health outcomes that paradoxically are comparable to, or in some cases better than, those of their U.S. white counterparts. ● What About The Father? ○ Indirect influence of risk for adverse birth outcomes: ■ Father’s attitude. ■ Father’s behavior. ■ Relationship between mother and father. ■ Hispanic paradox. ● Low Birth Weights Comparing Nations: ○ U.S. has a low birthweight rate of about 8.2% ranking worse than most developed nations. ○ Worldwide, far fewer lowbirthweight babies are born today than 20 years ago. ○ Neonatal deaths have been reduced by a third as a result. ● Consequences : ○ High risk infants and children: ■ Are later to smile, to hold a bottle, to walk, and to communicate. ○ In middle childhood, formerly SGA children: ■ Have similar brain volume. ■ Remember that risk analysis gives odds, NOT CERTAINTIES!\ ● Complications During Birth: ○ When a fetus is at risk, birth complications become likely: ■ Example cerebral palsy: a condition marked by impaired muscle coordination (spastic paralysis) and/or other disabilities..caused by damage to the brain before or at birth. ○ Anoxiarelated damage (an absence of oxygen) related to varied factors, such as: ■ Genes. ■ Birthweight. ■ Gestational age. ■ Drugs in bloodstream. ● The New Family The Newborn: ○ Newborns seek to protect themselves with three sets of reflexes: ■ MAINTAINING OXYGEN : breathing, hiccups, sneezing. ■ MAINTAINING CONSTANT BODY TEMP : crying, shivering, tucking legs to body, pushing. ■ MANAGING FEEDING : sucking, rooting, swallowing. ○ Brazelton Neonatal Behavioral Assessment Scale (NBAS): ■ Test often administered to newborns that measure responsiveness and records 46 behaviors, including 20 reflexes. ■ Parents who watch their infant perform on the NBAS are amazed at the newborn’s responsesand this fosters early parentchild connection. ○ Other reflexes are not necessary for survival but signify the state of brain and body functions: ■ Babinski refle reflex action in which the big toe remains extended or extends itself when the sole of the foot is stimulated, abnormal except in young infants. ■ Stepping refle present a birth. Infants cannot support themselves alone. When the soles of their feet touch a flat surface they well attempt to walk by placing one foot in front of the other. ■ Palmar grasping refle: appears as early as 16 weeks and continues until 5 or 6 months. When an object is placed in the infant’s hand and stroke the palm, the infant will close it’s hand and grasp the object. ■ Moro refle: Present in newborns up to 4 or 5 months. It’s a sudden loss of support; the infant will feel like it’s falling and will spread out the arms. ● The Father: ○ Not only fathers, but the entire social network and culture are crucial influences: ■ Father’s role: ● Helping mother stay healthy. ● Helping mother manage stress. ● Providing legal acceptance of the birth. ■ Couvade: ● Symptoms of pregnancy and birth experienced by fathers. ● The Mother: ○ About half of all women experience physical problems after birth: ■ Between 8 and 15% of women experience postpartum depression. ● Feelings of sadness and inadequacy. ● Symptoms from baby blues to postpartum psychosis. ● May involves struggles with adequate baby care. ● Varied causes. ● Parent Alliance: ○ Parent alliance: ■ Involves commitment by both parents to cooperate in raising the child. ■ Is especially beneficial when infant is physically vulnerable. ● Bonding: ○ Parentinfant bond: ■ Bonding involves strong, loving connection that forms as parents hold, examine, and feed the newborn. ■ Early skintoskin contact is not essential for human bonding. ○ Kangaroo care benefits mothers, babies, and hospitals, saving space and medical costs in the ward in Manila. ■ Kangaroo care: a method for caring for premature babies in which infants are held skintoskin with a parent, usually the mother, for as many hours as possible every day.
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