Exam 2 Flashcards

1
Q

What are the weight gain recommendations for underweight women (BMI >18.5) during pregnancy?

A

Underweight: 1st trimester= 2.2 to 6.6 pounds per week. 2nd and 3rd trimester= 1 to 1.3 pounds per week. Totalling 28-40 pounds of additional weight gain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the weight gain recommendation for normal-weight women (BMI 18.5-24.9) during pregnancy?

A

Normal weight: 1st trimester= 2.2 to 6.6 pounds per week. 2nd and 3rd trimester= 0.8 to 1.1 pounds per week. Totalling 25-35 pounds of additional weight gain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the weight gain recommendation for overweight women (BMI 25-29.9) during pregnancy?

A

Overweight: 1st trimester= 2.2 to 6.6 pounds per week. 2nd and 3rd trimester= 0.5 to 0.7 pounds per week. Totalling 15-25 pounds of additional weight gain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the weight gain recommendation for obese women (BMI<30) during pregnancy?

A

Obese: 1st trimester= 0.5 to 4.4 pounds per week. 2nd and 3rd trimester= 0.4 to 0.6 pounds per week. Totalling 11-20 pounds of additional weight gain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the characteristics of chronic hypertension?

A

Pregnant women with chronic hypertension have it in the first 20 weeks of pregnancy because they had it before they were pregnant. This hypertension does not resolve itself after birth of baby.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the characteristics of gestational hypertension?

A

Pregnant women with gestational hypertension are diagnosed after 20 weeks of pregnancy. This will resolve itself after the birth of the baby. No proteinuria here (protein spilling over into urine).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the characteristics of preeclampsia?

A

Pregnant women are diagnosed with preeclampsia after 20 weeks of pregnancy. This can only be resolved through the delivery of a child. There is proteinuria here due to organ damage caused by high blood pressure. Warning signs of preeclampsia include hypertension, upper abdominal pain, headaches, facial swelling, dizziness, and sudden weight gain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the diet and supplement recommendations for those at risk of preeclampsia?

A

Calcium (1.5-2 grams/day) and vitamin D from a multivitamin. A healthy diet during the first 22 weeks of pregnancy will decrease risk, which includes 5 or more servings of produce and 21 or more grams of fiber. It is not recommended to eat processed meats, sugary drinks, and salty snacks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the risk factors for gestational diabetes in a person planning to become pregnant?

A

Obesity, personal history, family history, and glucose in urine. Certain ethnic groups also have higher chances of gestational diabetes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the risk factors for a fetus of a mother with gestational diabetes?

A

Increased risk of stillbirth after 20 weeks, congenital abnormalities, macrosomia (>10lbs), respiratory distress syndrome, and neonatal hypoglycemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How are high-risk individuals tested for gestational diabetes?

A

High-risk individuals are tested for gestational diabetes before 24 weeks of pregnancy. They take an oral glucose tolerance test. If they fail the first one, they are given the 75-gram glucose 2-hour test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the characteristics of women categorized as high risk for gestational diabetes?

A

High-risk individuals for gestational diabetes include having a strong family history of previous gestational diabetes and PCOS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is a normal-risk individual tested for gestational diabetes?

A

Normal-risk individuals are tested between 24 and 28 weeks of pregnancy. They are given the oral glucose tolerance test and if they fail, they are given the 75 gram glucose test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are general diet guidelines for women with gestational diabetes?

A

The total percentage of carbohydrates is 45% of daily calorie intake. A carb choice is worth 15 grams of carbohydrates. These carb choices should be spread out as much as possible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why does the US have one of the highest maternal mortality rates of all developed nations?

A

Our poor healthcare coverage and quality of care are two big reasons for our poor maternal mortality rating.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the types of high-risk pregnancies?

A

Prepregnancy BMI less than 18.5 or greater than 25, eating disorder, poverty, smoking and/or alcohol abuse, teenage pregnancy, several previous pregnancies, multiple fetuses, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

For women lactating within the first 0 to 6 months after giving, how many more calories do they need?

A

extra 500 calories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

For women lactating 6 to 12 months after the birth of a child, how many more calories do they need?

A

extra 400 calories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the function of prolactin in breastfeeding?

A

Prolactin is the hormone that actually starts milk production in breast tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the function of prolactin-inhibiting hormone (PIH) in breastfeeding?

A

Hormone released from the hypothalamus. Tells body to not secrete milk when it should not be secreted.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the function of oxytocin in breastfeeding?

A

Oxytocin initiates milk ejaculation/ let down from breasts. The infant triggers the release of oxytocin in the mother.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the composition of human breast milk?

A

Human breast milk is made of mostly water with high amounts of fat in addition to protein and lactose. Fat makes up 50% of the calories in breast milk. The main protein in breast milk is whey which provides 1.3 grams. Lactose is breast milk’s primary carbohydrate, enhancing calcium absorption. Breast milk can change over a single feeding and is based on the infant.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the composition of colostrum?

A

Colostrum is stage 1 milk. It is orange and yellow in color due to high levels of vitamin A. Colostrum has a laxative type effect on baby so it can release first bowel movement. Colostrum has lower fat content than mature milk. It has about 2 grams of protein in the form of whey which exceeds that of mature breast milk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How does colostrum benefit the baby?

A

Colostrum is considered liquid gold for several reasons. First, it is easy for the baby to digest. It has a laxative effect that allows the baby to release the first bowel movement of meconium. Colostrum has high levels of vitamin A.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the benefits of breastfeeding for the mother?

A

Mom has a reduced risk of ovarian and breast cancer, type 2 diabetes, heart disease, postpartum depression, osteoporosis, and helps loose weight by burning 500 calories per day.

26
Q

What are the benefits of breastfeeding for the child?

A

A child who is breastfed is leaner in the first year of life and gets a healthier gut microbiome. There is a reduced risk of infections, diabetes, SIDS, asthma, dermatitis, allergies, childhood cancer, and stressed baby.

27
Q

What is the optimal duration of breastfeeding?

A

Exclusive breastfeeding for the first 6 months of life. Breastfeeding with complementary foods for the next 6 months after. Ideally breastfeeding for a whole 2 years.

28
Q

What are the three stages of lactogenesis?

A

Stage 1: From birth to 2-5 days after birth. This is when milk is forming, but we still have colostrum.
Stage 2: Beings 2-5 days after birth. There is increased blood flow leading to discomfort and pain. Change in milk composition occurs here.
Stage 3: Begins 10 days after birth. This is when the milk composition becomes stable.

29
Q

Why do some women have an insufficient supply of milk?

A

There could be poor latch with or without sore nipples. The baby could be weak (especially pre-mature babies). Mother could not be pumping or feeding often enough to keep up with demand. There could have been a change in feeding pattern, like a mom going to work or a baby sleeping through the night.

30
Q

What is normal weight loss for a baby and what is considered malnutrition?

A

Normal weight loss is around 7% of birth weight within the first week of life. If weight loss is greater than 10%, then assess possible malnourishment.

31
Q

What are the characteristics of malnourished babies?

A

They are sleepy, unresponsive, weka cry with no tear production due to dehydration, and few wet diapers

32
Q

How many diapers do babies use per day?

A

5-7 wet diapers
3-4 poop diapers

33
Q

Who can be an important support figure for breastfeeding promotion?

A

Partner, maternal mother, healthcare team, and coworkers

34
Q

What are sore nipples?

A

Sore nipples are mild nipple discomfort among women initiating breastfeeding. Ways to counter this issue include proper positioning of the baby on the breast, proper cleaning with only warm water, letting breast air dry after a feeding, and using proper ointment on nipples after feeding.

35
Q

What are flat/inverted nipples?

A

Flat or inverted nipples do not extend far enough into the baby’s mouth, making it difficult to get a good latch. To counter this, the mother can rub her nipple or roll it between their fingers to get some protrusion. Mother can also use a pump if latching is not an option.

36
Q

What is letdown failure?

A

Letdown failure is when the milk does not come out the breasts. Ways to help counter letdown failure include oxytocin nasal spray, playing soothing music, have partner rub knuckles on breast feeder’s spine, go on a walk, and decrease amounts of caffeinated beverages.

37
Q

What is hyperactive letdown?

A

Hyperactive letdown is when there is milk glands are overactive and milk streams endlessly from the breasts. To counter this, a nursing mother should initiate let down and then let milk pour until it slows down then attach baby, the mother can also express milk until flow slows.

38
Q

What is hyperlactation?

A

Hyperlactation occurs when the milk volume being produced by the mother far exceeds the intake of the baby. To manage this, mother must reduce milk production by having the baby nurse on only one side and just expressing milk from the other breast. Cabbage leaves and cold compress can also be used to decrease production.

39
Q

What is engorgement?

A

Engorgement occurs when breasts are overfilled with milk. This occurs when the supply and demand aspect of breastfeeding is not yet established. The best way to prevent engorgement is to nurse infant frequently and to express milk before attaching to make it more comfortable for nursing mother. Analgesics can also be used here for pain.

40
Q

What is a plugged duct?

A

Obstructed or plugged duct is a localized blockage of milk resulting from milk stasis, milk remaining in the ducts. Treatment of a plugged duct is gentle massages, warm compresses, and complete emptying of milk from breasts.

41
Q

What is mastitis?

A

Mastitis is inflammation of the breasts commonly found in breastfeeding women. Treatment for mastitis includes frequent pumping, anti-inflammatory for pain, and possible antibiotics.

42
Q

What is low milk supply?

A

Low milk supply is usually caused by the mother not breastfeeding or pumping often enough or inefficient emptying of the breast caused by poor latch or incorrect flange sizing in pumps. Treatments can include galactagogue which is a drug used to increase milk supply and encouraging mother to pump every 2 to 3 hours.

43
Q

Can alcohol be consumed by a lactating mother?

A

Yes, but the mother must wait an amount of time that correlates to the amount of alcohol taken in. It is now recognized that alcohol is not a galactagogue; it can negatively affect infant motor development. Alcohol enters the breast milk and can overwhelm the infants immature system.

44
Q

How long should a woman who weights 120 pounds wait to breastfeed if she enjoyed 1 serving of wine?

A

2-3 hours

45
Q

Can nicotine be consumed by a lactating mother?

A

Yes. Smoking cigarettes can cause harm to an infant including otitis media, asthma, respiratory infections, and GI dysregulation. The current policy states that smoking is a risk factor for low milk supply, low fat content, and poor infant weight gain. However, nicotine itself is not considered a drug of abuse with adverse effects on infants during breastfeeding.

46
Q

Can marijuana be consumed by a lactating mother?

A

No. Marijuana should not be consumed by a lactating mother because there is evidence that shows a decrease in infant motor development at 1 year of age. There is also evidence of negative effects on DNA and RNA. It is current policy that THC is a drug of abuse that is contradicted during breastfeeding.

47
Q

Can a lactating mother have caffeine?

A

Yes, lactating mothers can consume caffeine because there have been no long-term effects of caffeine exposure during lactation documented. Mothers should limit caffeine intake to less than 200 mg/day

48
Q

What are the laws in Kentucky regarding breastfeeding?

A

Kentucky became a breastfeeding-positive state in 2019 when the Fair Labor Standard Act was passed to protect breastfeeding mothers. It states that you a mother can breastfeed in any private or public place and it needs to be a room other than a bathroom

49
Q

Hypertension is defined as having a blood pressure of > _______ mmHg systolic and >________ mmHg diastolic blood pressure.

A

140:90

50
Q

All forms of hypertension in pregnancy are related to chronic inflammation, oxidative stress, and damage to the endothelium of blood vessels. (T or F)

A

True

51
Q

A woman that develops hypertension during pregnancy characterized by _____ would likely be diagnosed with ________.

A

Proteinuria: preeclampsia

52
Q

Human milk composition is changeable over the course of a single day. (T or F)

A

True

53
Q

Breastfeeding is just as effective as other methods of birth control like the birth control pill. (T orF)

A

False

54
Q

The onset of milk secretion occurs during which stage of lactogenesis?

A

Lactogenesis II

55
Q

Where does breast milk fat come from?

A

Triglycerides from the mother’s blood and new fatty acids produced in the breast

56
Q

Individual fatty acids and other milk components (oligosaccharides, gangliosides, and glycoconjugates) resulting from the digestion of human milk are antimicrobial. (T or F)

A

True

57
Q

The concentration of protein synthesized in the breast is mostly affected by what?

A

The age of the infant

58
Q

How many feedings do newborns receive per day?

A

10-12

59
Q

The symptoms of mastitis and plugged duct are similar. However, ______ is accompanied by _____.

A

Mastitis: fever and flu-like symptoms

60
Q

Which herb is the most commonly used herbal galactagogue?

A

Fenugreek

61
Q

Freshly expressed breast milk left at room temperature can be considered safe for a baby for up to _____ hours.

A

6-8 hours