4.1c Other Nutritional Issues During Pregnancy, Nutritional Care, Teaching Flashcards
1
Q
Alcohol
A
- No safe amount at any point in pregnancy
- Teratogen causes the below
Birth defects
Impaired cognitive and psychomotor development
Emotional and behavioral problems
Growth restriction
CNS abnormalities
Facial dysmorphia
2
Q
Caffeine
A
- Less than 200 mg daily has been shown to be safe
3
Q
Artificial Sweeteners
A
- Aspartame should be avoided in patients with PKU
- PKU (Amino acid phenylalanine build up in body which results in health problems)
- DO NOT TAKE STEVIA (plant based sweetener)
- Nutrasweet, Sunett, Splenda are okay to take
4
Q
PICA
A
- Consuming non-food substances or excessive amount of low nutrition food
- Often influenced by cultural background
- Screening during first prenatal visit, every trimester, and if anemia is present
5
Q
Food Cravings
A
- Generally not harmful to satisfy cravings
6
Q
Types of vegetarianism
A
Lacto-Vegetarian - Consumes milk products
Lacto-Ovo Vegetarians - Consumes egg, dairy, plants
Vegans - Consumes only plant products
Vegetarians can obtain adequate nutrition for pregnancy
Vegans should be referred to nutritional counseling
7
Q
Gluten Free Diets
A
- Little to no evidence of gluten free benefits
8
Q
Nutritional Assessment
A
- Preformed before conception to recommend diet, lifestyle, weight changes before pregnancy
- Completed at first prenatal visit
9
Q
Health History
A
- Completed at first prenatal visit and provides nutrition needs and concerns
- Nutrition can be affected by DM, liver disease, cystic fibrosis, crohns disorder
- Adolescents and multiple gestations should be referred to nutrition counseling
- Bariatric surgery also has serious implications for nutritional health
10
Q
How to preform Nutrition Health Assessment
A
- Bariatric surgery has serious implications for nutritional health during pregnancy
- Information about medication, alcohol, tobacco, drugs
- Review of OB and gynecologic history may reveal nutritional concerns
- Important to note if pregnant woman is an adolescent
- Adolescent and multiple gestations are both important to note
11
Q
Nutritional Assessment Components
A
- Adequate income to support nutritional needs
- Dietary modifications
- Food allergies/intolerances
- All medication and supplements
- Unusual cravings, PICA, cultural dietary practices
- Presence of n/v, constipation, pyrosis (heartburn)
- Evidence of eating disorders (anorexia, bulimia, rigorous dieting)
12
Q
Anthropometric (Body) Measures
A
- Physical Assessment
- Height and weight during first prenatal visit
- Weight measured at each subsequent prenatal visit
- BMI determines how much weight should be gained
13
Q
Laboratory Testing
A
ONLY IMPORTANT ONES
- Hematocrit & hemoglobin
14
Q
Education
A
- Nutritional needs during pregnancy
- Appropriate weight gain throughout pregnancy
- Dietary planning
- Coping methods for nutrition related discomforts
- Appropriate use of supplements
- Avoid alcohol/tobacco/drugs
- Safe food preparation and handling
15
Q
Financial Programs
A
- Supplement Nutrition Assistance Program (SNAP)
- Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
16
Q
Nutrition Risks
A
- LBW
- Preterm Birth
- First trimester crucial for neural tube defect
17
Q
Weight Gain during Pregnancy
A
First Trimester
- Total weight gain 1-2 kg
Second & Third Trimester Underweight - 0.5kg per week Normal - 0.4kg per week Overweight - 0.3kg per week Obese - 0.2kg per week
18
Q
Helpful Teaching Strategies of Diet Planning
A
- Daily food guide is good education for most cultures and vegetarians
- Helpful strategy is to help patients plan daily menus that are affordable and have realistic preparation times
19
Q
Food Safety
A
- Impacts fetus possibly due to
- Ecoli
- Salmonella
- Listeriosis
- Toxoplasmosis
- Brucellosis
20
Q
HOW TO COPE
A
21
Q
Nausea and Vomiting
A
- Antiemetic Medications
- Vitamin B6
- Ginger
- Acupuncture
HYPERMESIS GRAVIDARUM (EXTREME VOMITING) - Causes weight loss, dehydration, electrolyte abnormalities
- Cure includes IV fluid replacement, electrolyte replacement, enteral tube feeding, TPN
22
Q
Constipation
A
- Increased fiber
- Adequate fluid intake 8-10 cups a day
- Regular Physical Activity
23
Q
Pyrosis
A
- Caused by reflux of gastric contents
- Eat small more frequent meals
- Do not consume fluid with food (drink in between meals)
- Avoid spicy foods
- Avoid lying down directly after eating
- Avoid wearing tight clothes around abdomen
24
Q
Adolescent Pregnancy
A
- Cephalopelvic disproportion (baby head too big for moms pelvis) is common
- Competition for nutrients from baby and mother
- Mom generally needs more nutrients in adolescent pregnancy
25
Q
Bariatric Pregnancy
A
Common Deficiencies - Folate - B12 - Iron (Iron deficiency long term effect after bariatric surgery) - Calcium - Vitamin D Screen for nutrient deficiencies, appropriate weight gain, provide supplemental nutrition Risks - Prematurity - Small for gestational age - NICU admission
