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clinical nutrition > Chapter 10 book notes > Flashcards

Chapter 10 book notes Flashcards

1
Q

In preparation for a healthy pregnancy, a woman can establish
the following habits:

A

-achieve and maintain a healthy body weight
-choose an adequate and balanced diet
-be physically active
-receive regular medical care
-avoid harmful substances

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2
Q

Infant birthweight correlates with:

A

-most important predictor of the infant’s future health and survival
–prepregnancy weight and weight gain during pregnancy

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3
Q

AN underweight women has a high risk of having a:

A

-low birthweight infant

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4
Q

low-birthweight (LBW):

A
  • a birthweight less than 5½ lb (2500 g);
    -indicates poor health in the newborn and poor nutrition
    status of the mother during pregnancy.
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5
Q

Low-birthweight infants are of
two different types:

A

-Some are premature; they are born early and are of a weight appropriate
for gestational age (AGA).
-Others have suffered growth failure in the uterus; they may or may not be
born early, but they are small for gestational age (SGA)

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6
Q

Low birthweight infants are more likely to:

A

-contract diseases and are nearly 40 times more likely to die in the first month of life.

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7
Q

Optimal birthweight
for a full-term infant is:

A

-6.8 to 7.9 lb (about 3100 to 3600 g).

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8
Q

Infants born to women who are obese are more likely to be
large for gestational age, weighing:

A

-more than 9 pounds.

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9
Q

Women who are obese are likely to suffer from: what during pregnancy:

A

-gestational diabetes, hypertension, and complications during and infections
and hemorrhage after the birth.

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10
Q

Women who are overweight have a higher risk of giving birth to infants that have:

A

-heart defects or other abnormalities.
-long term effects include: child obesity, heart disease, type 2 diabetes, and asthma throughout life.

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11
Q

A major reason that the mother’s prepregnancy nutrition is so crucial is that it determines
whether her

A

-uterus will be able to support the growth of a healthy placenta during the first month of gestation

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12
Q

placenta:

A

-an organ that develops inside the uterus early in pregnancy,
-maternal and fetal blood circulate in close proximity and exchange materials.
-The fetus receives nutrients and oxygen across the placenta
-waste from fetus is picked up from mother to be excreted by kidneys or lungs

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13
Q

The placenta also produces numerous and diverse of:

A

-hormones that act to maintain pregnancy and prepare the mothers breasts for lactation.

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14
Q

A healthy placenta is essential for the developing:

A

-fetus to attain its full potential.

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15
Q

amniotic:

A

-the “bag of water” in the uterus in which the fetus floats.

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16
Q

umbilical cord:

A

-the ropelike structure through which the fetus’s veins and arteries reach the placenta;
-the route of nourishment and oxygen into the fetus and the route of waste
disposal from the fetus.

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17
Q

A newly fertilized ovum is called a:

A

-zygote

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18
Q

A zygote begins as a single cell and rapidly divides to become a:

A

-blastocyst, 5 days old and ready for implantation
-blastocysts floats down into the uterus where it will embed itself in the inner uterine wall.

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19
Q

Adverse effects such as smoking, drug abuse, and malnutrition during implantation can lead to:

A

-failure to implant
-or abnormalities such as neural tube defects that can cause the loss of developing embryo.

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20
Q

At eight weeks, the fetus has a complete:

A

-central nervous system,
-a beating heart,
-a fully formed digestive system,
-fingers and toes,
-beginnings of facial features.

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21
Q

During the last 7 months of pregnancy (fetal period) what happens?

A

-fetus grows
-critical periods of cell division and development occur in organ after organ.

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22
Q

Most successful pregnancies last:

A

38 to 42 weeks and produce a healthy infant weighing between 6.8 and 7.9 pounds.

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23
Q

critical period:

A

-a period of rapid cell division.
-a period during development in which certain events occur that will have irreversible
effects on later developmental stages;

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24
Q

Fetus brain and heart are developed at ?? weeks=
what about their lungs?

A

-14 weeks
-24 weeks

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25
Q

can the effects of malnutrition during critical periods be reversible?

A

-NO

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26
Q

The effects of malnutrition during critical periods of pregnancy are seen in defects
of the:

A

-nervous system of the embryo, in the child’s poor dental health,
-and in the adolescent’s and adult’s vulnerability to infections and possibly higher risks
of diabetes, hypertension, stroke, or heart disease.

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27
Q

Energy needs change as the

A

-pregnancy progresses

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28
Q

How many extra kcalories are needed during the second trimester? what about the third?

A

-340
-450

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29
Q

Ample carbohydrates (ideally how much ??) is necessary to fuel the:

A

-175 grams or more per day but no less than 135 grams
-the fetal brain and spare protein needed for fetal growth.

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30
Q

protein RDA for pregnancy calls for ?? grams per day more than for nonpregnant women:

A

-25

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31
Q

Vitamins famous in their roles in cell reproduction and needed in large amounts during pregnancy:

A

-folate and vitamin B12

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32
Q

Why are more vitamins needed during pregnancy?

A

-the mothers blood volume rises, the number of red blood cells rise, which requires more cell division thus more vitamins.

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33
Q

recommendation for folate during pregnancy increases from 400 to:

A

-600 micrograms a day.

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34
Q

folate plays an important role in preventing

A

-neural tube defects

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35
Q

neural tube:

A
  • the embryonic tissue that later forms the brain and spinal cord.
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36
Q

By the time a woman suspects she is pregnant, usually around the sixth week of
pregnancy, the embryo’s

A

-neural tube normally has closed.

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37
Q

NTD occurs when

A

-the tube fails to close properly

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38
Q

Each year in the United States, an estimated ??? pregnancies are affected by an NTD

A

-3000

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39
Q

Two most common types of NTD are:

A

-anencephaly (no brain)
-spine bifida (split spine)

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40
Q

Anenceohaly

A

-upper end of neural tube fails to close
-brain is either missing or fails to develop
-end in miscarriage or infants die shortly after birth

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41
Q

spina bifida:

A

-one of the most common types of neural tube defects;
-characterized by the incomplete closure of the spinal cord’s bony encasement
-allowing the spinal cord to bulge through.

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42
Q

moderate cases of spina bifida include:
severe cases will lead to:

A

-curvature of spine, muscle weakness, mental handicaps, and other ills
-death

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43
Q

Risk factors for neural tube defects:

A

-family history of NTD
-maternal diabetes or obesity
-overheating or fever
-maternal use of certain medications
-inadequate folate

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44
Q

Pregnant women need a greater amount of vitamin B12 in order to:

A

-assist folate in the manufacture of new cells.

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45
Q

Choline:

A

-choline is needed for normal brain and spinal cord development of fetus
-large amounts are transported from mother to fetus via placenta, which depletes maternal stores.

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46
Q

Prenatal supplements do not include:

A

-choline
-so choline is rich in eggs, dairy products, legumes, and meats/seafood

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47
Q

Vitamin D and minerals (calcium, phosphorous, fluoride, and magnesium) are in great demand during pregnancy and help build:

A

-skeleton
-insufficient intake will produce abnormal fetal bone growth and tooth developemnt.

48
Q

In the final weeks of pregnancy, more than ???? milligrams of calcium a day is
transferred to the fetus.

A

-300

49
Q

Why does the body conserve iron especially well during preganacy?

A

-menstruation ceases
-absorption of iron increases up to 3fold and due to rise in transferrin.

50
Q

To improve iron status of women before & during pregnancy, they are advised to eat:

A

-heme iron foods (meat, poultry, and seafood)

51
Q

The developing fetus draws heavily on the mother’s iron stores to create stores of
its own to last through the first:

A

-four to six months after birth

52
Q

During the second and third trimesters of pregnancy, the hormone ?? , which regulates iron balance,
is suppressed, and the mobilization of iron from maternal stores is enhanced.

A

-hepcidin

53
Q

Women who enter pregnancy with iron-deficiency anemia are at increased risk of delivering

A

-low-birthweight or preterm infants

54
Q

Women most likely to benefit from prenatal supplements during pregnancy include those who:

A

-do not eat adequately
- those carrying twins or triplets
-those who smoke cigarettes,
-those with alcohol use disorder or substance abuse disorder.

55
Q

Special Supplemental Nutrition Program for Women, Infants, and
Children (WIC):

A

-a high-quality, costeffective health care and nutrition services program administered by the U.S. Department of Agriculture
for low-income women, infants, and children who are nutritionally at risk.
-WIC provides supplemental foods, nutrition education, and referrals to
health care and other social services.

56
Q

How many people recieve WIC benefits each month? and most of them are?

A

-7 billion
-infants and young children

57
Q

Supplemental Nutrition Assistance Program (SNAP) provides-

A

-a debit card that can also help to stretch the grocery dollars of those in need

58
Q

Pregnancy weight gains within the
recommended ranges are associated with fewer

A

-surgical births,
-greater number of healthy birthweights

59
Q

Excessive weight gain in the U.S. is ?? than inadequate weight gain.

A

-more common

60
Q

Recommended weight gain for:
underweight BMI=
healthy weight=
overweight=
obese=

A
  • 28 to 40lbs
    -25 to 35lbs
    -12-25lbs
    -11 to 20lbs
61
Q

ideal weight gain pattern for a woman who begins pregnancy at a healthy weight

A

-is 3½ pounds during the first trimester and 1 pound per week thereafter

62
Q

A sudden, large weight gain is a danger signal, however, because it may indicate the
onset of

A

-preeclampsia

63
Q

The weight the pregnant woman gains includes

A

-maternal and fetal fat & lean tissue
-as well as the placenta and amniotic fluid.
-fat she gains is used later for lactation.

64
Q

Pregnant women and physical activity

A

-low impact activities and avoid sports in which they might be fall or be hit by other people or objects
-avoid saunas, steam rooms, and hot whirlpools

65
Q

Food aversions and cravings that arise during pregnancy are probably due to:

A

-hormone induced changes in taste and sensitivities to smells, and they quickly disappear after
the birth.

66
Q

Common nutrition related concerns of pregnancy:

A

-food sensitivities, nausea, heartburn, and constipation.

67
Q

Heartburn

A

-burning sensation in the lower esophagus near the heart
-benign
-as growing fetus puts increasing pressure on womens stomach, acid may back up and create burning sensation in throat.

68
Q

Why does constipation happen during pregnancy?

A

-hormones of pregnancy alter muscle tone and thriving infant crowds intestinal organs.

69
Q

Women with preexisting diabetes can give birth to infants that are :

A

-large
-suffer physical and mental abnormalities
-or experience other complications like hypoglycemia or respiratory distress

70
Q

gestational diabetes:

A

-glucose intolerance during pregnancy
-resolves after birth but some women can develop type 2 diabetes later especially if they are overweight.

71
Q

Weight gains after pregnancy increase the risk of

A

-gestational diabetes in the next pregnancy

72
Q

Gestational diabetes can lead to:

A

-fetal or infant sickness or death, surgical birth and high infant birthweight.
-though the risk of these outcomes falls dramatically when it is identified early and managed properly

73
Q

At first prenatal visit women who are (two factors) will be screened for gestational diabetes

A

-overweight (BMI higher than 25)
-have one or more additional risk factors for type 2 diabetes (family history, high blood pressures, etc.)

74
Q

All pregnant women not previously diagnosed with diabetes are tested for glucose intolerance at:

A

-24 to 28 weeks’ gestation

75
Q

2 types of hypertension during pregnancy:

A

1)chronic hypertension
2)gestational hypertension

76
Q

chronic hypertension:

A

-in pregnant women, hypertension that is present
and documented before pregnancy;

77
Q

gestational hypertension:

A

-high blood pressure that develops in the second half of pregnancy and usually resolves after childbirth.

78
Q

Both types of hypertension produce risk factors in mother and fetus such as:

A

-heart attack & stroke
-growth restriction, preterm birth, and separation of placenta from the wall of the uterus before birth.
-preeclampsia

79
Q

preeclampsia:

A

-a condition characterized by hypertension and protein in the urine during pregnancy.
-multisystem syndrome involving placental stress, inflammation, and metabolic dysfunction.

80
Q

WHO recommends what to women at high risk of preeclampsia

A

-calcium supplementation

81
Q

Preeclampsia usually occurs:

A

-with first pregnancies and almost always appear after 20 weeks gestation

82
Q

What is the cure of preeclampsia?

A

-delivery of baby, leading cause of preterm deliver
-symptoms regress after 48 hours of delivery

83
Q

What organs does preeclampsia affect?

A

-circulatory system
-liver
-kidneys
-brain

84
Q

Ecampsia

A

-severe complication during pregnancy in which seizures occur
-happens when preeclampsia continues to occur.

85
Q

signs and symptoms of preeclampsia (8):

A

-hypertension
-protein in urine
-upper abdominal pain
-severe headaches
-swelling of hands, feet, and face
-vomiting
-blurred vision
-sudden gain (1lb per day)

86
Q

What % of pregnant women in the U.S. smoke?

A

-10%

87
Q

What substances in cigarette smoke are toxic to fetus?

A

-nicotine, carbon monoxide, arsenic, and cyanide.

88
Q

What does smoking do to the fetus?

A

-restricts blood supply
-limits delivery of oxygen nutrients and removal of wastes
-damage fetal blood vessels (seen at age 5)

89
Q

SIDS

A

-sudden infant death syndrome
-unexplained death that sometimes occurs in a healthy infant, linked to smoking

90
Q

Lead contaminant in pregnant women:

A

-moves readily across placenta, inflects severe damage on developing fetal nervous system.
-dietary calcium will help

91
Q

Mercury contaminant in pregnant women:

A

-impairs fetal growth and harms the developing brain and nervous system

92
Q

FDA and EPA encourage pregnant and lactating women to eat at least

A

8 ounces to 12 ounces of seafood weekly.

93
Q

listeriosis:

A

-a serious foodborne infection that can cause severe
brain infection or death in a fetus or newborn;
-caused by the bacterium Listeria monocytogenes, which is
found in soil and water.

94
Q

Which vitamin, in excess, can be harmful to pregnant women?

A

-all of them but in particular A (fetal malformations)

95
Q

Pregnancy and caffeine;

A

-less than 200 milligrams per day
-more than 3 cups of coffee a day can lead to miscarriage and low birthweight.
-1-2cups a day is good

96
Q

fetal alcohol spectrum disorders:

A

-a spectrum of physical, behavioral, and cognitive disabilities caused by prenatal alcohol exposure.

97
Q

fetal alcohol syndrome (FAS):

A

-most severe end of spectrum
-the cluster of symptoms seen in an infant or child whose mother
consumed excessive alcohol during her pregnancy.
-FAS includes, but is not limited to, brain damage, delayed
growth, intellectual disabilities, and facial abnormalities.

98
Q

alcohol-related neurodevelopmental disorder (ARND):

A

-a condition caused by prenatal alcohol exposure
-conditions include cognitive impairments, learning difficulties, and behavioral problems

99
Q

For every child diagnosed with FAS, many more with FASD go undiagnosed until:

A

-problems develop in the preschool years

100
Q

Common complications among adolescent mothers include:

A

-iron deficiency anemia
-prolonged labor, due to mother physical immaturity)

101
Q

a pregnant teenager with a BMI in the normal range
is encouraged to gain about ?? pounds to reduce the likelihood of a low-birthweight
infant

A

35

102
Q

The AAP recommends that infants receive breast milk for at least the first ?? months of life and beyond for as long as mutually desired by mother and child

A

12

103
Q

The AAP and the AND recognize exclusive
breastfeeding for ?? months and breastfeeding with complementary foods for at least 12 months as an optimal feeding pattern for infants

A

-6

104
Q

What is the only acceptable alternative to breast milk?

A

-iron fortified formula

105
Q

A nursing women produces about how many ounces of milk a day?

A

-25

106
Q

during the first 6 months of lactation a women should eat an additional ?? kcalories per day above regular intake

A

-330 because she spends 500kcalories in order to produce milk

107
Q

During the second 6 months of lactation, an additional
?? kcalories each day is recommended

A

400

108
Q

Many women who follow recommendations for gestational
weight gain and breastfeeding can readily return to prepregnancy weight by ?? months.

A

6

109
Q

nutritional deprivation of the mother USUALLY reduces the ??, not the ??, of her milk

A

-quantity
-quality

110
Q

The nutrients in breast milk that are most likely to decline in response to prolonged inadequate intakes are:

A

-vitamins—especially vitamins B6, B12, A, and D

111
Q

The volume of breast milk produced depends on:

A

-how much milk the infant demands, not on how much fluid the mother drinks

112
Q

How much water is a nursing women advised to drink?

A

-13 cups a day

113
Q

Foods with strong or spicy flavors (such as onions or garlic) may
alter:

A
  • the flavor of breast milk
114
Q

Birth control pills that combine the hormones estrogen and progestin seem to:

A

-suppress milk output,
-lower the nitrogen content of the milk,
-shorten the duration of breastfeeding

115
Q

progestin-only contraceptive pills have:

A

-no effect on breast milk or breastfeeding and are
considered appropriate for lactating women

clinical nutrition (26 decks)

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