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NUR 4020 > ch. 15 maternal nutrition > Flashcards

ch. 15 maternal nutrition Flashcards

1
Q

healthy people 2030 goal for maternal nutrition

A

increase the proportion of women delivering a live birth who had a healthy weight/BMI prior to pregnancy
- increase the proportion of women of childbearing potential with intake of atleast 400 mg of folic acid from fortified foods and dietary supplements

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2
Q

maternal weight (3)

A
  • pre pregnancy weight (BMI going INTO the pregnancy)
  • maternal weight gain
  • factors that influence weight gain: age, parity, nutritional status
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3
Q

formula for BMI

A

(weight (Ibs)/height (in))^2 x 703^12

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4
Q

underweight pre pregnancy (1)

A

higher risk of:
- low birth weight (or growth restricted) babies

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5
Q

overweight/obese pre pregnancy (4)

A

higher risk of:
- gestational diabetes
- HTN
- preeclampisa
- complications during labor and birth

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6
Q

babies of obese women (6)

A

higher risk of:
- PTB
- cesarean birth
- macrosomia
- stillbirth
- congenital anomalies
- childhood obesity

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7
Q

maternal weight gain (underweight) (BMI, total weight gain, rates of weight gain)

A

BMI: <18
total weight gain: 28-40 Ibs
rates of weight gain in 2/3 trimester (Ib/week): 1 (1-1.3)

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8
Q

maternal weight gain (normal) (underweight) (BMI, total weight gain, rates of weight gain)

A

BMI: 18.5 - 24.9
total weight gain: 25-35
rates of weigh gain in 2nd/3rd trimester (Ib/week): 1 (0.8-1)

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9
Q

maternal weight gain (overweight) (underweight) (BMI, total weight gain, rates of weight gain)

A

BMI: 25.0 - 29.9
total weight gain: 15-25
rates of weight gain in 2nd/3rd trimester (Ib/week): 0.6 (0.5-0.7)

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10
Q

maternal weight gain (obese) (underweight) (BMI, total weight gain, rates of weight gain)

A

BMI: >30
total weight gain: 11-20
rates of weight gain in 2nd/3rd trimester (Ib/week): 0.5 (0.4-0.6)

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11
Q

average maternal weight gain distribution (5)

A

1) fetus, placenta, amniotic fluid: 11 Ibs/ 5 kg
2) uterus: 2 Ibs/0.9 kg
3) increase blood volume: 4 Ibs/1.8 kg
4) breast tissue: 3 Ibs/1.4 kg
5) maternal stores: 5-10 Ibs./ 2.3-4.5 kg

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12
Q

macronutrients needed during pregnancy (3)

A

protein
fats
carbohydrates

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13
Q

micronutrients needed during pregnancy (2)

A
  • fat soluble vitamins (A,D,E,K)
  • water soluble vitamins (folate/folic acid, vitamin B6, vitamin B12, vitamin C)
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14
Q

minerals needed during pregnancy (6)

A
  • iron
  • calcium
  • magnesium
  • zinc
  • choline
  • iodine
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15
Q

fluids/electrolytes needed during pregnancy (3)

A
  • fluids
  • sodium
  • potassium
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16
Q

protein during pregnancy (6)

A
  • provides amino acids for fetal development, blood volume expansion, and growth of breasts & uterus
  • contributes to body’s overall energy metabolism
  • pregnant women: need 71g daily (1.5x)
  • non pregnant women: 46g daily
  • animal products, dairy, lentils, nuts
  • soy, rice, or almond milk good for vegetarians or lactose intolerant women
17
Q

fat during pregnancy (6)

A
  • more completely absorbed in pregnancy
  • results in marked increase in serum lipids, lipoproteins, cholesterol, & decreased elimination in the bowel
  • pregnant women: 20-35% of daily calorie intake (ONLY 10% SATURATED FATS)
  • essential fatty acids needed for development of fetal CNS
  • fish (salmon, hallibet, tuna), soybean/canola oil, flaxweeds, walnuts good
  • AVOID MERCURY IN FISH (toxic to babies)
18
Q

carbohydrates during pregnancy (5)

A
  • body’s primary source of energy
  • provides fiber necessary for proper bowel function
  • if not adequate, body uses protein instead of carbs for energy
  • needs for pregnant women increase, esp in 2nd/3rd trimester
  • breads, cereals, pastas, brown rice, dairy, fruits & veggies are good sources
19
Q

minerals during pregnancy (ca/phos (3), iodine (3), Na (3), Zinc (4), Mg (3), Iron (4))

A

1) calcium/phosphorus: 700-1250 mg/day
- both involved in fetal bone/teeth development, energy & cell production
- MILK, eggs, meat

2) iodine: essential part of thyroid hormone: thyroxine
- 220 mcg/day with iodized salt/seafood good
- impaired brain development in fetus if low (lower IQs)

3) sodium: 2-3g
- metabolism & regulation of fluid balance
- AVOID CHIPS, HAM, SAUSAGE, SEASONINGS

4) zinc: 11 mg/day
- protein metabolism & synthesis of DNA and RNA
- needed for normal fetal growth and breast milk production
- shellfish (crab meat, shrimp lobster), meats, poultry good

5) magnesium: 350 mg/day
- cellular metabolism & structural growth
- dark leafy greens, fish, beans, seeds, nuts, yogurts, grains

6) iron: 27mg/day (supplements)
- growth of fetus, placenta, expansion of maternal BV
- animal products, dark green veggies
- deficiency anemia: decrease in O2 carrying capacity of blood, can have negative affect on fetal brain development, can cause CONSTIPATION (increase fluids)

20
Q

fat soluble vitamins: A,D,E,K (3)

A
  • toxicity possible (if w/prenatal or too much)
  • stored in liver
  • not excreted in urine -> can build up + utilize throughout the body
21
Q

water soluble: C/B vitamins (4)

A
  • must be ingested daily
  • folic acid (risk of spina bifida if NOT)
  • need to prevent neural tube defects
  • ingestion of folic acid has essentially eliminated neural tube defects in fants (work of MARCH OF DIMES)
22
Q

vegetarianism (4)

A

1) lacto-ovo vegetarians
- include milk, dairy products, eggs

2) lacto-vegetarian
- dairy products, no eggs

3) vegans
- no food from any animal sources
- how would you teach a vegan or vegetarian how to get protein in their diet?

4) need meal planning to ensure obtaining necessary nutrients
- table 15.4

23
Q

factors influencing nutrition (7)

A
  • common discomforts of pregnancy
  • must educate patients to be careful with: complementary/alternative therapies, nonnutritive sweeteners, energy drinks, mercury in fish
  • food borne illnesses: salmonella, listeria (maintain refrigerator temp at 40F and freezer 0F, refrigerate leftovers within 2 hours, no hot dogs/meat unless steaming hot, avoid feta/brie/camembert/blue-veined/queso fresco/queso blanco, no meat spreads/raw milk, avoid smoked seafood (high salt)
  • lactase deficiency (lactose intolerant)
  • cultural/ethic/religious influences: symbolic significance, raw meat risk for worms
  • psychosocial factors: sharing of food symbol of friendliness, warmth, eating disorders (anorexia - fear of weight gain, bulimia - binging/purging)
  • PICA eaters: persistent cravings (dirt, corn starch, ice, soap, paint, burned matches, only during pregnancy, iron deficiency anemia is a MAJOR PROBLEM, poor weight gain and fetal impaction also potential issue)

TIP: EVERYTHING CROSSES THE PLACENTA

24
Q

nutritional care of pregnant adolescent (5)

A
  • adolescents considered physiologically mature 4 years after menarche (16 years old if started at 12)
  • iron, calcium, folic acid, zinc
  • vitamins A,D,E,B6
  • dietary patterns
  • counseling issues - who preps food?

NUR 4020 (36 decks)

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