Teratogenic Exposure (Nursing)

00:01 Now let's talk about exposure to substances that might not be good for the baby.

00:06 Now the general term is teratogenic. So we want to think in this case about when? Because babies can be exposed to teratogens at different points in the pregnancy, sometimes it's okay and sometimes it's not.

00:20 Now we've just talked about all the development and the formation that happens at the very beginning of a pregnancy.

00:26 We were talking about development at two weeks, at four weeks, at eight weeks and the formation of organs that are ultimately going to become the skin and the heart.

00:36 That was happening at about eight weeks.

00:39 If you think about pregnancy and when most people realize they're pregnant, sometimes it's well after this formation.

00:46 So when we think about informing clients about exposure to harmful substances, it really needs to happen long before pregnancy, otherwise it might be too late.

00:56 So I want to spend some time now talking about what those teratogens might actually be.

01:02 So let's think about some things that would be considered teratogenic.

01:05 So, smoking certainly would be in this category and this includes vaping, so don't forget about that.

01:11 Alcohol use.

01:13 Cannabis or other recreational drugs, so even though States are working to legalize cannabis, it doesn't mean that it's safe for pregnancy.

01:22 Also, viruses. So thinking about things like rubella, and varicella and sexually transmitted diseases and infections can also be extremely harmful to a fetus.

01:33 And the last thing we want to think about are environmental exposures like pollution.

01:38 So thinking about where someone lives and where they work and what kind of hobbies they have might be important to explore so we can reduce the risk of teratogenic exposure.

01:48 To help us remember all the different teratogens that might be out there, we have a mnemonic called TORCH, and each of these letter stand for one of the things that might be considered a teratogen.

02:00 The T stands for Toxoplasmosis.

02:03 Toxoplasmosis is an organism that can be found both in dirt and also in cat feces.

02:09 If you've ever heard someone say, you can't have a cat when you're pregnant, you can have a cat, cats are great, unless you're a dog person but you can have a cat and realize that if you're going to be changing the litter box, you probably should wear gloves and that will take care of it, so cats are fine.

02:27 O stands for other. And this really encompasses all the other types of organisms and things that might harm the fetus that we're not going to cover in the other areas, but things like syphilis, HIV, parvovirus, enterovirus or anything else, that would be covered under O.

02:45 R stands for rubella or German measles.

02:49 If you contract rubella during pregnancy, that can be harmful for the fetus.

02:53 It's one of the reasons why making sure that someone is rubella immune is really important prior to pregnancy.

03:00 CMV, cytomegalovirus.

03:03 This is going to be particularly important for clients who were working with young children.

03:07 They tend to carry CMV. Again, we can draw a titer for CMV prior to pregnancy and find out if someone is immune or not.

03:15 And the last letter, H, stands for HSV or herpes simplex virus.

03:21 This is an example of one of the sexually transmitted infections that can actually be transmitted from the pregnant patient to the fetus and cause harm.

03:30 In a nutshell, you want to remember to ask the clients about where they live, where they play, and what other activities they have to make sure they're not at risk of being exposed to anything that could be harmful to the fetus.