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91 Cards in this Set
- Front
- Back
What is the first trimester of pregnancy crucial for?
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Embryonic and fetal organ development
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What are neural tube defects?
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Failures in the closure of the neural tube
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Who shows higher incidence of neural tube defects?
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Infants of women with poor folic acid intake
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Why is neural tube closure important?
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Because it is required for normal formation of the spinal cord
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What factors affect the outcome of pregnancy?
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1. Health status
2. Self-care 3. Family 4. Socioeconomic status 5. Education 6. Nutrition 7. Biology (Genetics) 8. Environment |
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What foods are the sources of folic acid/folate?
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1. Liver
2. Legumes (peas, beans, lentils) 3. Vegetables (asparagus, spinach, broccoli, leafy greens) 4. Fruits (papaya, avocado, orange) 5. Breakfast cereals 6. Wheat germ 7. Pasta 8. Rice 9. Bread 10. Egg 11. Corn (in order of good to adequate sources) |
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What is the recommended daily consumption of folic acid for women wanting to get pregnant?
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400 mcg
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What factors contribute to the increase nutrient needs of pregnant women?
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1. The uterine-placental-fetal unit
2. Maternal blood volume and constituents: During pregnancy the total blood volume increases by 50% in women in their first pregnancies and more than this in multifetal pregnancies. 3. Maternal mammary development 4. Metabolic needs: BMRs are about 20% higher in pregnant women, which includes the energy costs for tissue synthesis |
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What is the primary role of protein intake?
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Provide amino acids for the synthesis of new tissues
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What is the estimated energy expenditure for the first trimester?
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Same as in the prepregnancy state (i.e. 2000 kcal/day)
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What is the RDA during the second trimester?
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340 kcal greater than the prepregnancy needs
(i.e. 2000 + 340 = 2340 kcal) |
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What is the RDA during the third trimester?
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462 kcal greater than the prepregnancy needs
(i.e. 2000 + 462 = 2462 kcal) |
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What is the optimal weight gain during pregnancy?
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Not known
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What can occur with severely underweight pregnant women?
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They are more likely to have preterm labor and give birth to LBW infants
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How is BMI calculated?
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Weight / (Height)^2
{weight divided by height squared} |
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What is the RDA during the second trimester?
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340 kcal greater than the prepregnancy needs
(i.e. 2000 + 340 = 2340 kcal) |
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What is the RDA during the third trimester?
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462 kcal greater than the prepregnancy needs
(i.e. 2000 + 462 = 2462 kcal) |
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What is the optimal weight gain during pregnancy?
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Not known
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What can occur with severely underweight pregnant women?
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They are more likely to have perterm labor and give birth to LBW infants
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How is BMI calculated?
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Weight / (Height)^2
{weight divided by height squared} |
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What is classified as underweight?
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BMI < 19.8
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What is classified as normal weight?
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BMI = 19.8 to 26
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What is classified as overweight?
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BMI = 26 to 29
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What is classified as obese?
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BMI > 29
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What is the recommended weight gain during pregnancy for the normal weight?
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25 to 35 pounds
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What is the recommended weight gain during pregnancy for the obese?
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15 to 25 pounds
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What is the recommended weight gain during pregnancy for the underweight and teenagers?
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28 to 40 pounds
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What is the recommended weight gain during pregnancy for the women carrying twins or multifetuses?
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Prepregnant Kcal needs + 300 Kcal/fetus/day
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What is the pattern of weight gain for singleton pregnancy during the first trimester?
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Should only gain up to 3.5 pounds total
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What is the pattern of weight gain for singleton pregnancy during the second and third trimester?
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1 pound per week
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What is the recommended daily intake of fluids?
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8 to 10 glasses (2.3 L)
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What are the indicators of nutritional risk in pregnancy?
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1. Adolescence
2. Frequent pregnancies (3 within two years) 3. Poor fetal outcome in a previous pregnancy 4. Poverty 5. Poor diet habits with resistance to change 6. Use of tobacco, alcohol, or drugs 7. Weight at conception under or over normal weight 8. Problems with weight gain - any weight loss, weight gain less than 1 kg/mo after first trimester, weight gain more than 3 kg/mo after the first trimester 9. Multifetal pregnancy 10. Low Hgb and/or Hct values |
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What is the recommended daily amount of ferrous iron during pregnancy?
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30 mg, starting at twelve weeks of gestation
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If maternal anemia is present, what is the recommended daily dose of iron?
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60 to 120 mg
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What are the benefits of iron supplementation?
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Enhances maternal iron status, which lead to increases in Hgb, serum iron, mean red cell volume, saturation of iron transport protein transferrin, and serum ferritin
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What helps with iron absorption?
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Vitamin C
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What may be tolerated even in people with lactose intolerance?
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1. Yogurt
2. Sweet acidophilus milk 3. Buttermilk 4. Cheese 5. Chocolate milk 6. Cocoa |
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What are some sources of calcium for women who do not drink milk?
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1. Fish (sardines, salmon)
2. Beans and legumes 3. Leafy greens 4. Fruits (figs, OJ with calcium) 5. Pesto sauce or cheese sauce |
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What consideration is important to remember with pregnant women who are vegans?
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They are generally anemic and have a higher tendency to tear during vaginal births
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What is the recommended daily calcium intake if it appears low?
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600 mg
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What is the benefit of calcium supplements?
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It can relieve leg cramps caused by imbalances in the calcium-phosphorus ratio
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Why are bone meal supplements not recommended for pregnant women?
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These supplements generally contain lead, which can freely cross the placenta and cause lead poisoning to the fetus
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Who are at risk of insufficient vitamin and mineral intake?
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Adolescents and low-income women
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What are good sources of magnesium?
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1. Dairy products
2. Nuts 3. Whole grains 4. Green leafy vegetables |
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What is the function of sodium during pregnancy?
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Maintaining body water balance
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What is common with pregnancy?
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Edema, which is a response to the fluid-retaining effects of elevated levels of estrogen
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What is the recommended daily sodium intake during pregnancy?
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1.5 g/day, with an upper limit of 2.3 g/day
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What is the benefit of potassium?
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Reduced risk of hypertension
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What is the recommended intake of potassium?
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8 to 10 servings of unprocessed fruits and vegetables daily, along with moderate amounts of low-fat meats and dairy products to reduce sodium intake while providing adequate amounts of potassium
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What is zinc?
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A constituent of numerous enzymes involved in major metabolic pathways
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What is zinc deficiency associated with?
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Malformations of the CNS in infants
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What are the fat-soluble vitamins?
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Vitamins A, D, E, K
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Where are fat-soluble vitamins stored?
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Body tissues
(so, in the event of prolonged overdoses, these vitamins can reach toxic levels) |
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What is the function of vitamin E?
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Protection against oxidative stress
(and pregnancy is associated with increased oxidative stress) |
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What does oxidative stress cause?
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Preeclampsia
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What is preeclampsia?
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1. Disease encountered after 20 weeks of gestation or early in puerperium
2. A vasospastic disease process characterized by increasing HTN, proteinuria, and hemoconcentration |
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What are sources of vitamin E?
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1. Vegetable oils and nuts (good sources)
2. Whole grains and leafy green vegetables (moderate sources) |
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What complication can arise with EXCESSIVE intake of vitamin A?
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Congenital malformations
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What is the function of vitamin D?
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Helps with absorption and metabolism of calcium
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What are water-soluble vitamins?
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Small vitamins that are readily excreted in the urine
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What is the recommended daily intake of folate/folic acid?
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600 mcg
(50% more than prepregnancy status) |
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Why is the increased intake of folate/folic acid recommended during pregnancy?
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Because of the increase in RBC production, as well as the nutritional requirements of the rapidly growing cells in the fetus and placenta
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What is the function of vitamin C?
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Plays an important role in tissue formation and enhances the absorption of iron
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What is the recommended daily intake of vitamin C?
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50 mg
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What is pica?
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The practice of consuming nonfood substances (e.g. clay, soil, laundry starch) OR excessive amounts of foodstuffs low in nutritional value (e.g. ice chips or freezer frost, baking powder to soda, and cornstarch)
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What complications can arise with pica?
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1. Lower hemoglobin levels
2. Risk that the nonfood items will be contaminated with heavy metals or other toxic substances |
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What are food cravings?
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The urge to have ice cream, pickles, pizza, or some specific food
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What is believed to cause pica and food cravings?
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An innate drive to consume nutrients missing from the diet
(no research has supported this hypothesis) |
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What is the focus of the efforts to improve the nutritional health of pregnant adolescents?
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1. Nutrition knowledge
2. Meal planning 3. Food preparation and selection skills of young women 4. Promoting access to prenatal care 5. Developing the nutrition interventions and educational programs that are effective with adolescents 6. Striving to understand the factors that create barriers to change in the adolescent population |
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What causes preeclampsia?
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The cause is unknown, but there has been speculation that poor intake of calcium, magnesium, vitamin B6, and protein might foster its development
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What nutritional concepts are especially important for women who choose to exercise during pregnancy?
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1. Liberal amounts of fluids should be consumed before, during, and after exercise, because dehydration can trigger premature labor
2. The calorie intake should be sufficient to meet increased needs of pregnancy and the demands of exercise |
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What are the recommended daily nutritional requirements for pregnant and lactating women?
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1. Pregnancy: 300+ cal/day
2. Lactating: 200+ cal/day = 500 cal/day 3. Fluids: 8-10 glasses/day 4. Lactating 3000ml/day 5. Nutritional dense food: *Whole grains 7 + *Veggies 3-5 svg/day, all colors! *Protein 60-80 gm/day *Dairy 3+ *Fats 3 tsp |
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What is the recommended intake of folic acid and iron for women after giving birth?
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Decreased since maternal blood volume decreases to nonpregnant levels
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What is the recommended intake of calcium for women after giving birth?
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600 mg
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What complications can arise from smoking during lactation?
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1. Impaired milk production
2. Risk of passive smoking by infant |
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What complications can arise from alcohol use during lactation?
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1. Impairment of the infant's psychomotor development
2. Impairment of the milk-ejection reflex |
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What complications can arise from caffeine use during lactation?
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Can lead to a reduced iron concentration in milk and consequently contribute to the development of anemia in the infant
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What does nutritional care and teaching involve?
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1. Acquainting the woman with the nutritional needs during pregnancy and the characteristics of an adequate diet, if necessary
2. Helping her to individualize her diet so that she achieves an adequate intake while conforming to her personal, cultural, financial, and health circumstances 3. Acquainting her with strategies for coping with the nutrition-related discomforts of pregnancy 4. Helping her use nutrition supplements appropriately 5. Consulting with and making referrals to other professionals |
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What is WIC?
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A program that provides vouchers for selected foods to pregnant and lactating women, as well as infants and children at nutritional risk
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What is especially important for adolescents and women younger than 25 years to consume?
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Adequate amounts from the milk, yogurt, and cheese food group
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What is the recommended daily intake of dairy products for adolescents?
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At least 3 to 4 cups
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How many calories should lactating women consume daily?
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1800 kcal
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What vitamins and minerals should be added to a lactating woman's diet?
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Zinc, vitamin B6, folic acid, and calcium
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Why do lactating women need calcium?
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To allow for both milk formation and maintenance of maternal bone mass
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What is the food plan of women with diabetes?
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Usually includes four to six meals and snacks daily, with the daily carbohydrate intake distributed fairly evenly among the meals and snacks
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What may be effective in reducing the severity of nausea?
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1. Antiemetic medications
2. Vitamin B6 3. Ginger |
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What suggestions are helpful with alleviating nausea and vomiting?
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1. Eat dry, starchy foods (dry toast, crackers)
2. Avoid consuming excessive amounts of fluids early in the morning 3. Eat small amounts of food frequently (q 2-3 hrs) 4. Avoid skipping meals 5. Avoid sudden movements 6. Decrease intake of fried or fatty foods 7. Breathe fresh air 8. Eat foods served at cool temperatures 9. Avoid brushing teeth immediately after eating 10. Try salty and tart foods 11. Try herbal teas |
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What can help prevent constipation?
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Improved bowel function generally results from increasing the intake of fiber in the diet because fiber helps to retain water within the stool, creating a bulky stool that stimulates intestinal peristalsis
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What are some sources of fiber?
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Bran and whole grain products, popcorn, and raw or lightly steamed vegetables
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What are vegetarian diets?
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Vegetables, fruits, legumes, nuts, seeds, and grains
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What are semivegetarians?
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In addition to the vegetarian diet, include fish, poultry, eggs, and dairy products, but not beef or poultry
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