NCM MCF Outline Gumban (Midterm) PDF

lOMoARcPSD|48167982 NCM MCF Outline Gumban ( Midterm) Medical Surgical Nursing (Riverside College) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Jhanel Mariano ([email protected]) ...

lOMoARcPSD|48167982 NCM MCF Outline Gumban ( Midterm) Medical Surgical Nursing (Riverside College) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Jhanel Mariano ([email protected])  lOMoARcPSD|48167982 NCM MCF (GUMBAN) PHASES OF OVARIAN CYCLE TYPE OF MENSTRUAL DISORDERS 1. Follicular phase -Period of follicle growth (1-4 days) or (Day 1 of Amenorrhea MENSTRUATION TOPICS menses- ovulation) Premenstrual Syndrome (PMS) A.) Physical changes in females during puberty DAY 1-GnRH stimulates the release FSH & LH. Menorrhagia B.) Phases of menstrual cycle 2. Luteal -A period of corpus luteum activity (day 14-28). Metrorrhagia C.) Signs of ovulation Phase/Secretory -The egg bursts from its follicle, but ruptured follicle D.) Composition of menses Phase/Post ovulatory stays on the surface of the ovary. 2 TYPES: E.) Characteristics of Normal menstrual cycle phase Primary -menstruation does not begin at F.) Type of Menstrual Disorders PHASES OF MENSTRUAL CYCLE Amenorrhea puberty. G.) Menopause 1. Menstrual Phase -Day 1 (onset of menstruation) shedding off. Secondary- Normal and regular menstrual -Follicle starts to develop and producing estrogen. periods that become increasingly abnormal and NORMAL MENSTRUAL PHYSIOLOGY ABBREVIATIONS/ HORMONES 2. Proliferative -Immediately after the menstrual flow which occur irregular or absent. INVOLVED phase/Estrogen during the first 4-5 days of the cycle. Premenstrual Syndrome -Unpleasant or uncomfortable sensation. Estradiol (E) Phase -Endometrium is very thin. (PMS) Progesterone (P) PHASE OF UTERINE CYCLE Menorrhagia -Abnormal uterine bleeding and is characterized Gonadotropin-releasing hormone (GnRH) 3. Secretory -The corpus luteum (under the direction to LH) by heavy and prolonged menstrual bleeding. Follicle stimulating hormone (FSH) Phase/Luteal causes the gland of the uterine endometrium to Metrorrhagia -Bleeding between menstrual period. Luteinizing hormone (LH) Phase/Progestational become corkscrew. -Short term Phase (15-21) MENOPAUSE MENSTRUATION/MENSTRUAL CYCLE -If fertilization does not occur, the corpus luteum in Cessation of menstruation 4. Ischemic Phase (22- the ovary begins to regress after 8-10 days. Usually occurs between the ages of 40 & 55 (mean age of 51.3) Episodic uterine bleeding in response to cyclic hormonal changes. Purpose To bring an ovum to maturity. 28) -As it regress the production of estrogen and Atrophy of ovaries progesterone decreases. Reduced estrogen production (hot flashes) Renew the uterine tissue bed that will be responsible for SIGNS OF OVULATION the ova’s growth should it be fertilized. Physiologic effects Vaginal dryness Slight increase in the body temperature. Osteoporosis (lack of bone mineral density) 4 Body Hypothalamus Mittlechmerz Urinary incontinence Structures Pituitary glands Ferns Test involved in the Ovaries Spinnbarkeit mucus physiology of Uterus Mittlechmerz -1 sided, lower abdominal pain. menstrual cycle Hypothalamus -Releases Gnrh Ferns Test -The cervical mucus forms fernlike patterns caused by crystallization of sodium chloride when placed on (Luteinizing Hormone-Releasing Hormone glass. Pituitary glands -Releases FSH and LH. Spinnbarkeit mucus -Refers to the strethy, egg white quality of cervical (Also known as gonadotropin) fluids around ovulation. Ovaries -Oocyte begin to grow and mature. COMPOSITION OF MENSES -Producing a follicular fluid high in estrogen and some progesterone. Blood from ruptured capillaries. FERTILIZATION -As the follicle surrounding the oocyte grows it is propelled Mucin from the gland A.) Terms used to describe fetal growth. toward the surface of the ovaries. Fragments of endometrial tissue B.) The Sperm Cell -Visible as water blister and is termed as Graafian follicle. Microscopic, atrophied and unferitilized ovum C.) The Egg Cell Uterus -Illustrates uterine changes that occur monthly as a result CHARACTERISTICS OF NORMAL MENSTRUAL CYCLE D.) Fertilization of stimulation from the estrogen and progesterone. CHARACTERISTICS DESCRIPTION E.) Implantation PHYSICAL CHANGES IN FEMALES DURING PUBERTY Beginning (menarche) Average age at onset (12-14 yo) F.) Embryonic and Fetal structures Average range: 9-17 yrs G.) Primary Germ Layer Female Reproductive Maturation of uterine wall. uterine wall Estrogen and Progesterone Interval between cycle Average, 28 days; cycles of 23-35 days not unusual TERMS USED TO DESCRIBE FETAL GROWTH Female Secondary Sex Breast development Duration of menstrual flow Average flow: 4-6 days; ranges 2-9 days Ovum -Ovulation to fertilization. Characteristics Wider hips and fat deposition Zygote -Fertilization -Implantation not abnormal Body Hair Embryo -Implantation 5-8 weeks. Amount of MF Average 30-80ml per menstrual period External genitalia development Fetus -5-8 weeks until term. Color of MF Dark red PHASES OF MENSTRUAL CYCLE Conceptus -Developing embryo and placental structures Odor Similar to marigold Ovarian Cycle throughout pregnancy. Uterine Cycle Age of viability -24 weeks or at a point the fetus reaches 500-600g. Downloaded by Jhanel Mariano ([email protected])  lOMoARcPSD|48167982 -Ranges 800-1200ml or pocket fluid larger than THE SPERM CELL EMBRYONIC AND FETAL STRUCTURES 8cm. Head -Contains the DNA. Placenta and fetal -Serves as the lungs, kidneys and digestive tract in -Hydramnios 9 more than 2,000ml in total pockets Acrosome -Tip of the head used to penetrate the egg cell. membranes uteru. Amniotic Fluid of fluids larger than 8cm on ultrasound. Midpiece -Contains the mitochondria which supplies the -Derived from latin word “pancake” -May occur in diabetes. energy. -Grows from the trophoblastic cells at the beginning -Urine adds to the quantity of amniotic fluid. Flagellum -Provides a whip-like movement in order to propel it of pregnancy to an organ of about 15-20cm -A distance in kidney function may cause forward. diameter covering about half the surface area of oligohydramnios detected by ultrasound (amniotic the uterus. fluid index should be at least 5 and greater than THE EGG CELL Decidua -Uterine lining that continues to grow or function 2cm) Corona Radiata -An outer layer of follicular (granulosa) cells that form under the influence by HCG secreted by trophoblast around a developing oocyte. cells. PRIMARY GERM LAYER -To supply vital proteins to the cell. Chorionic Villi -Fingerlike projection from the trophoblast cells Group of cells in an embryo formed in the earliest stages of embryonic Zona pellucida -Thick extracellular coat that surrounds eggs, into the uterine endometrium to begin formation of development. functions to prevent polyspermy. the placenta. GERM LAYER BODY PORTION FORMED Cytoplasm -Gelatinous liquid that fills the inside of a cell. -Consist of central core of connective tissue and Ectoderm CNS, PNS Nucleus -Double-membraned organelle that contains the fetal surrounded by a double layer of cells that Skin, Hair, Nails, Tooth enamel, Sense organs genetic material and other instruction (store DNA bad produce placental hormones: Mucous membrane of the anus, mouth and nose maintains integrity).  Somatotropin Mammary gland  Human placental lactogen Mesoderm Supporting structures of the body (connective FERTILIZATION  Estrogen and Progesterone tissue, bones, cartilage, muscle, ligaments, and -Union of the ovum and spermatozoon. Crytrophoblast -Middle layer or Langhan’s layer. tendons) -Usually occurs in the outer third of the fallopian tube (ampullar portion). -Protects the embryo from infectious organisms Upper portion of the urinary system.(kidney & -1 ova reaches maturity and released by ovulation. (before 20-24 wks) ureter) -An ovum is capable for fertilization for only about 24-48H. -Spirochete of syphilis early in pregnancy. Reproductive system -Functional life of spermatozoon is only about 48-72. Human Chorionic -First placental hormone produced. Heart, Lymph nodes and circulatory system and FERTILIZATION PROCESS Gonadotropin -Can be found in the maternal blood as early as 1st blood cells. Sperm  Cervix  Body of Uterus  Fallopian tube  Waiting ovum (HCG) missed menstrual period or shortly after Endoderm Lining of pericardial, pleura and peritoneal cavities. (By the combination of movement by their flagella and uterine contraction) implantation. Lining of GIT, Respiratory tract, Tonsils, Parathyroid Sperm  Ovum cluster around the protective layer of corona cells -Level vary throughout pregnancy. and Thyroid and Thymus glands 2.5 ml containing 50-200 mil -Ejaculation of seminal fluid. -Will completely become in the mother’s blood 1-2 spermatozoa wks after birth. PREGNANCY PHYSICAL CHANGES -Released by the sperm. Function of HCG  To ensure corpus luteum of the ovaries continue A.) Care of the Mother and the Fetus during Perinatal Period Hyaluronidase -Dissolves the layer of cells protecting to produce progesterone and estrogen. B.) Classification of Pregnancy Signs the ovum.  May play the role in suppressing maternal C.) Physiologic Changes in Pregnancy  1 ovum able to penetrate the cell membrane of the ovum. immunologic response to placental tissue is not a. Discomfort in Pregnancy  Cell membrane changes its compositions and becomes impervious to other detected or rejected as foreign substance. b. Reproductive System spermatozoa ovum fuse to form zygote. Progesterone -Hormone that maintains pregnancy. c. Cardiovascular System Chromosomal material of sperm -Maintains endometrial lining during pregnancy. d. Urinary System Sperm and ovum carried 23 chromosomes (22 autosomes 1 sex -Rises progressively at about 12th week during the e. Endocrine System chromosomes)= 46 chromosomes remainder of pregnancy. f. Pituitary Gland -Reduce contractility of the uterus preventing D.) Minor Discomforts in Pregnancy IMPLANTATION premature labor. Zygote -Migrates over 3-4 days to the body of the uterus. Estrogen -Produced by the 2nd product of the syncytial cells CARE OF THE MOTHER AND THE FETUS DURING PRENATAL PERIOD Blastocyst -Formed as a large cell that collect in the periphery of (primary estriol) of the placenta. Pregnancy - Period before childbirth from the moment of the ball leaving fluid space surrounding inner cell mass. -Contributes in the mammary gland development in conception/fertilization to the start of labor. Trophoblasts -The cells in the outer in the outer ring. preparation for lactation and stimulates growth to - 40 weeks usually lasts about The inner cell mass = the embryoblast that will form the accommodate the growing fetus. 3 Phases of Pregnancy  antepartum or prenatal (before birth) Human Placental -Produced by the placenta. embryo.  intrapartum (during birth) Mitotic cell division or cleavage begin (24H) Lactogen (Human -Growth promoting and lactogenic properties.  postpartum (after birth)  Divisions continue, by the time it reaches the body it consists of 16-50 cells Chorionic -Serves in regulating maternal glucose protein and (morula) Somatomammotropin) fat levels. Downloaded by Jhanel Mariano ([email protected])  lOMoARcPSD|48167982 Labor (childbirth) -the expulsion of the products of conception 3 Frequent Sense of having no void PHYSIOLOGIC CHANGES IN PREGNANCY (conceptus) from the uterus when it has reached urination frequently Categories of  Local the stage of viability. 6 Chadwick’s Color change of the Physiologic  Systemic Abortion -The coming out of the fetus before 20 weeks. Sign vagina from pink to Changes Puerperium -the postpartum period of 4 to 6 weeks purplish-blue (violet) Local -confine in the reproductive organ.  Missed period 6 Goodell’s sign Softening of the cervix Systemic -affecting the entire body.  Breast soreness 6 Hegar’s Sign Softening of the lower DISCOMFORT IN PREGNANCY Common Pregnancy  Increased basal body temperature uterine segment. 1. Breast tenderness Symptoms  Morning sickness 6 Sonographic Characteristic ring is 2. Palmar erythema or pruritus  Frequent urination evidence of evident (signifies 3. Constipation  Fatigue gestation sac presence gestational 4. Nausea, vomiting and pyrosis ( heartburn) sac) 5. Fatigue-increase metabolic requirement and hormonal changes CLASSIFICAITON OF PREGNANCY SIGNS 12 Fatigue General feeling of 6. Frequent urination Presumptive signs -subjective and cannot be assessed by examiner. tiredness 7. Muscle cramps Probable signs -can be documented by examiner 12 Uterine Uterus can be palpated 8. Supine hypotension –when lying on her back Positive signs - are those which cannot be mistaken for any other enlargement over symphysis pubis. 9. Varicosities condition. 16 Ballottement When lower uterine 10. Hemorrhoids segment is tapped on a 11. Heart palpitation Presumptive Signs  Nausea and vomiting bimanual examination, 12. Backache  Amenorrhea the fetus can be felt to REPRODUCTIVE SYSTEM  Breast changes rise against abdominal Uterus Change to Globular in Shape  Fatigue wall Softening of the Uterus Occurs (Hegar’sSign)  lethargy Presence of Uterine Contraction (Braxton – Hick’s)  Urinary frequency Uterine Souffle and Funic Souffle Dominant blowing sound TIME FROM PRESUMPTIVE PROBABLE POSITIVE DESCRIPTIO  Quickening Softening of The Cervix (Goodell’s Sign) IMPLANTATIO FINDING FINDING FINDING N Probable Signs  Uterine changes Operculum ( mucus plug) - on the cervical canal N (WEEKS)  Cervical changes Fullness of breast, tingling sensation and heaviness 18 Quickening Fetal  Positive Pregnancy Test movement Montgomery’s Tubercle Prominent  Chadwick’s Sign felt by RESPIRATORY SYSTEM  Outlining of fetal body woman Marked Congestion And Stuffiness Positive Signs  Fetal heart rate 20 Fetal Fetal Upward movement of the diaphragm  Fetal movement movement movement Oxygen Consumption Increased By 20%  Fetal outline on Ultrasound felt by can be CARDIOVASCULAR SYSTEM (BLOOD)  X-ray report examiner palpated Blood Volume: -From 30 –50% ( plasma increases faster than the RBC through / hemodilution) resulting in physiologic anemia CLASSIFICATION OF PREGNANCY SIGNS abdomen TIME FROM PRESUMPTIVE PROBABLE DESCRIPTION 20 Braxton Periodic -starts to increase at the end of 1st tri, peaks at 28-32 IMPLANTATION FINDING FINDING Hicks sign uterine weeks and continue to increase throughout the end of (WEEKS) tightening 3rd trimester 1 Serum Tests of blood serum occurs. Anemia in 1st trimester: Hb < 11 g/dL; Hct< 33% laboratory reveal the presence of 20 Fetal Fetal outline Pregnancy : 2nd trimester: Hb < 10.5 g/dL; Hct< 32% tests human chorionic outline felt can be 3rd trimester: Hb < 11 g/dL; Hct< 33% gonadotropin hormone. by palpated Anemia - decreased red blood cells 2 Breast Feeling of tenderness, examiner through Most Common Iron and folate deficiency changes fullness, or tingling: abdomen. Causes in Anemia Decreased iron absorption enlargement and 24 Linea nigra Line of dark Inadequate dietary intake darkening of areola. pigment on Medical condition 2 Nausea & Nausea or vomiting on the abdomen Iron needs during fetus -350-400 mg of iron Vomiting arising. 24 Melasma Dark pigment pregnancy Mother –500 mg 2 Amenorrhea Absence of on face. Total average need of iron for pregnant is 800 mg menstruation 24 Striae Red streaks gravidarum on abdomen Downloaded by Jhanel Mariano ([email protected])  lOMoARcPSD|48167982 CARDIOVASCULAR SYSTEM (HEART) CORTISOL –influence biochemical changes THALIDOMIDE -used to treat morning sickness - Increase cardiac output 25-50% HPL -helps to regulate your metabolism. Effect: limb defects such as phocomelia/amelia - Increase HR by 10 beats  Estrogen PHOCOMELIA -a rare condition that causes very short limbs. - Heart is slightly enlarged and displaced or shifted anteriorly to the left of the Antagonist to insulin  cortisol AMELIA -the birth defect of lacking one or more limbs. chest cavity by the diaphragm effect  somatotropin -is an antibiotic -Palpitation  placental lactogen TETRACYCLINE Effect: tooth enamel deficiencies and possible long bone -BP does not rise PITUITARY GLAND deformities that were originally formed normally URINARY SYSTEM LH and FSH - no production - Infection that mostly affects the skin and lymph nodes. VARIABLE CHANGE increased melanocyte stimulating hormone RUBELLA VIRUS - can spread from person to person through contact with Renal function Changes to excrete waste from maternal and oxytocin (GERMAN droplets from an infected person’s fetal blood supplies - produced in late pregnancy -prostaglandin MEASLES) Hearing impairment Glomerular filtration rate Increased by 50% - affect smooth muscle contractility , may initiate and trigger labor Cognitive and motor challenge Blood Urea Nitrogen Decreased by 25%, BUN of 15mg/100 ml or prolactin - stimulate lactation Cataracts higher is abnormal Effects: Creatinine Decreased in pregnancy; 24hour urine sample - MINOR DISCOMFORTS IN PREGNANCY Cardiac defects ( commonly ductus arteriosus and 90-180 ml/min; serum creatinine >1mg/100ml is 1. Nasal Congestion pulmonary stenosis) abnormal. 2. Nausea And Vomiting IUGR Renal threshold for sugar Decreased to allow slight spillage 3. Palpitations Thrombocyropenia purpura -decreased platelet Ureter and bladder Increase in urinary output but also physiologic 4. Breast Tenderness Facial cleft ( cleft lip and palate) function increase in urinary stasis (bladder infections and 5. Shortness Of Breathing pyelonephritis are more likely). 6. Backache TORCH Bladder capacity Increased by 1,000. 7. Abdominal Discomfort -an abbreviation collectively the diseases that are known to Cross the Diameter of ureters Increased by 25% 8. Braxton Hick’s Contraction Placenta. Frequency of urination Slightly increased in first trimester, increases to 9. Urinary Frequency 10-12 times per day in the last 2 weeks of 10. Constipation To -toxoplasmosis pregnancy. 11. Leukorrhea R- rubella Fluid retention Increased aldosterone production → increased 12. Hemorrhoids C- cytomegalovirus sodium reabsorption and fluid retention 13. Muscle Cramps H-herpes simplex - Kidneys increase in size and function; increase output 14. VaricoseVeins - protozoan infection , ingestion of raw or inadequately - Glucose -should be negative 15. Ankle Edema cooked meat, handling cat stool in soil.  Bun FETAL EFFECT: RENAL FUNCTION TESTs  Creatinine TERATOGENS CNS damage , microcephaly, intracerebral  Creatine clearance Toxoplasmosis decalcification Retinal deformities  Glomerular filtration rate (GFR) TERATOGENS – any factor, chemical or physical that adversely affects the fertilized ovum , PREVENTIVE MEASURES: BUN -nitrogen in the blood that comes from the embryo or fetus Avoid intake of undercooked meats waste product urea ( normal - less than 15 Can involve either sexually transmitted or systemic Avoid changing cat litter box mg/100 ml) infections Avoid working in the soil in he area where cats may CREATININE -waste product of muscle metabolism (normal- Teratogenic Organism that can cross the placenta can be viral , defecate less than 1 mg/100 ml) Maternal bacterial or protozoan - virus usually causes only a rashes and mild systemic CREATINE CLEARANCE -renal function test( 24h urine creatine) Most cause relatively mild, flulike symptoms in a illness to the mother. GLOMERULAR –blood filtered by glomeruli per min Infections woman but can have much more serious effects on a Rubella FETAL DAMAGE INCLUDES: FILTRATION RATE (GFR) fetus or newborn ( German deafness ENDOCRINE SYSTEM Factors that 1. Strength of teratogen Measles) mental and motor challenges PLACENTA -as an endocrine organ with the following cataracts hormones: influence the 2. Timing of teratogenic insult ( in the 2nd to 8th weeks amount of gestation) fetus is vulnerable to injury) cardiac defects ( PDA - patent ductus arteriosus and ESTROGEN -breast and uterine enlargement, increase pulmonary stenosis sodium and water retention, fat deposit and damage a 3. Teratogen's affinity for specific tissue teratogens can Cytomegalovirus - a herpes virus family causing few maternal symptoms; blood coagulation. ( CMV) transmitted by droplet infection by person to person. PROGESTERONE -maintaining endometrium, inhibits uterine cause: What are the Thalidomide NEUROLOGICAL DAMAGE SUCH AS: contractility, development of breast for lactation Hydrocephalus hCG -maintain the progesterone production of teratogens Tetracycline Rubella virus( German Measles) Microcephaly corpus luteum Downloaded by Jhanel Mariano ([email protected])  lOMoARcPSD|48167982 Spasticity or with eye damage (optic atrophy, - an association between mumps infection during the Cigarette Smoking - growth restriction/ risk of SIDS ( sudden infant chorioretinitis, chronic liver disease) first trimester of pregnancy and an increase in the rate death syndrome) - a viral infection that typically affects the mouth, genitals, of spontaneous abortion or intrauterine fetal death. or anal area. Treatment: ENVIRONMENTAL TERATOGENS Herpes Simplex Management: -focused on relieving symptoms until the body's immune -those that directly or deliberately ingested ( Genital Herpes Cesarian Birth is recommended system fights off the infection. - pesticides and carbon monoxide (automobile Infection) Identifying signs and symptoms such as painful perineal - There are currently no medicines to treat the mumps exhaust), or vaginal lesion. virus. Metal and Chemical - paints, Instilling awareness about the spread of infection and Chickenpox Effect to pregnancy: Hazards - formaldehyde ( paper manufacturing) the importance of obtaining history of exposure. (Varicella) - During the first 20 weeks of pregnancy, has an - Lead – sniffing, gasoline Administration of acyclovir (Zovirax) oral or IV during increased risk for congenital varicella syndrome. (a rare Effect to fetus: pregnancy. group of serious birth defects that can cause: scars on - could increase the chances of having a Safer sex is advised to lessen exposure and to other STI. the skin, problems with the arms, legs, brain and miscarriage, a stillbirth, or a child with a birth eyes defect. OTHER VIRAL DISEASES THAT MAYBE TERATOGENIC -an acute infectious viral disease affecting the brain and Radiation -X-ray ( should be taken only at term ) Measles (rubeola) -is a highly contagious viral infection of the respiratory spinal cord causing weakness, paralysis, and wasting of -Maternal stress - myths about the effect of being system Poliomyelitis muscle also called infantile paralysis frightened or surprised while pregnant - spreads by coughing and sneezing Effect to pregnancy: -life threatening - incidence of abortion is relatively high, DANGER SIGNS OF PREGNANCY -are part of the enterovirus family of viruses (which also - if the pregnancy goes to term parturition is expected to Rapid weight gain ( over 2 lbs per week in 2nd trimester includes polio viruses and hepatitis A virus) that live in be normal. Swelling of face or fingers Flashes or light or dots before the eyes the human digestive tract - contagious respiratory illness caused by influenza that Blurring of vision Coxsackievirus - can spread from person to person. infect the nose, throat, and lungs Severe headache - others have no symptoms, but suddenly develop high Influenza Effect to pregnancy: Decrease urine output fever, headache, and muscle aches, sore throat, - Increased risk of stillbirth, but its effect on preterm Vaginal Bleeding abdominal discomfort, or nausea. birth, fetal death, SGA and LBW is still uncertain. -caused by a virus transmitted primarily by Aedes Viral hepatitis -is liver inflammation due to a viral infection can mosquitoes. profoundly affect pregnant women causing significant Zika virus disease No treatment or vaccine is recommended maternal and perinatal morbidity and mortality with Prevention is through hand washing before eating; some strains much worse than others. avoiding crowds of young children at daycare or -because they may transmit viral infection during nursery setting pregnancy viral diseases that Measles Potentially Measles may adversely Mumps Teratogenic Mumps affect non- rubella Vaccines Rubella immune pregnant Poliomyelitis women and their Vaccine that can be given during Pregnancy: fetuses/neonates TDAP (Tetanus, Diphtheria, Pertussis) Vaccine -a viral infection that primarily affects salivaproducing Inactivated Flu vaccine (salivary) glands - transmitted by person to person through direct TERATOGENIC DRUGS/SUBSTANCE contact with saliva or respiratory droplets of a person Thalidomide( morning Effect to pregnancy: infected with mumps. sickness/ anticancer ) - amelia or phocomelia ( total or partial absence of Mumps Clinical manifestation includes: extremities) fever, Mepiridine( Demerol) - intrauterine growth retardation headache, and heroin muscle aches, Cocaine ( compromise - spontaneous abortion, preterm labor, meconium tiredness, blood flow) staining, intrauterine growth loss of appetite, restriction/retardation swollen salivary glands Alcohol Effect : fetal alcohol syndrome, small for gestational age and cognitively challenged, and craniofacial deformity Downloaded by Jhanel Mariano ([email protected])