Module 3 Objectives (Exam 2)

Question 1

Identify approximate recommended weight gain during pregnancy

Answer 1

• 25-35 pounds for woman of normal pre-pregnant weight

Question 2

Ferrous sulfate/gluconate

Answer 2

Iron is present in many foods but in small amounts. During Pregnancy ~1000 mg of absorbed iron above maternal iron stores are needed. Health care providers often perscribe Iron supplements of 30 mg per day. Women who take high doses of iron also need Zinc supplements because iron interferes with the absorbtion of this mineral. It may be hard to tolerate taking without food, but you should take it with food. For best results it should be taken with water or orange juice but not with coffee, tea, or milk.

Side Effects:

Nausea, Vommiting, Heart burn, epigastric pain, constipation, diarrhea, Black Stools

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Question 3

Prenatal vitamins

Answer 3

Iron (Encourage increase in fluids and fiber to prevent constipation)
Folic Acid

Question 4

Identify factors that may impact ability to achieve adequate prenatal nutrition

Answer 4

• Eating disorders
• Diabetes
• Multiple fetuses
• Adolescence
• Substance abuse
• Vegans (Vaginas)
• Poverty
• Culture (Retards)
• Anemia before pregnancy
• Pica
• Women who follow fad diets
• obesity

Question 5

Identify relationships between low maternal weight gain and fetal/neonatal outcomes

Answer 5

1. Fetal growth restriction
2. Preterm birth
3. Low birthweight infants

Question 6

Develop a teaching plan and nutritional regimen for the pregnant woman

Answer 6

• Weight Gain

1. 1.1 to 4.4 pounds during first trimester
2. One pound per week after first trimester
3. Weight gain depends on weight before pregnancy

• Carbohydrates

1. Complex Carbohydrates such as cereal, pasta, and potatoes should be the major source.
2. Fiber helps prevent constipation and slows gastric emptying causing a sensation of fullness.
3. Avoid simple carbohydrates such as table sugar and pixie stick.
4. fruits and veggies contain simple sugars along with good nutrients so eat them up. Yummy in my Tummy

• Fats

1. Provide energy and fat soluble vitamins
2. Do not restrict fat intake.
3. Conola, soybean, and walnut oils are good :)

• Protein

1. 71 grams per day during second half of pregnancy
2. If calories are too low and protein is used to provide energy then fetal growth may be imparied.
3. To increase intake eat more protein rich foods instead of protein powders or drinks.

• Take folic acid and iron supplements
• Calcium

1. Not removed from teeth during pregnancy
2. Dairy products are the best source
3. Also present in legumes, nuts, dried fruit, brocoli and dark green leafy veggies.
4. spinichi and chard contain calcium but decrease calcium availability (Poor sources)
5. More calcium is needed by women younger than 18 years
6. Women who do not eat dairy should take supplements unless they can meet the need
7. Should be taken with Vitamin D
8. Do not take with iron

• Sodium - excessive amounts should be avoided
• Whole Grain - 7-9 oz
• Vegetables and Fruits

1. 3 - 3.5 cups of fruit daily (Prego)
2. Dark Green, Orange, or Dark Yellow are the best veggies

• Dairy - 3 cups daily
• Concentrated Sugars, Fats, and oils should be eaten sparingly (6 - 8 teaspoons of unsaturated oils per day)
• DO NOT EAT - Shark, Sword Fish, King Mackerel, and tilefish
• Eat up to 12 oz shrimp, salon, pollack, catfish, and canned light tuna (but only 6oz white albacore tuna) each week
• Do not eat raw food
• Avoid luncheon meats and hot dogs
• Avoid soft cheeses unless made with pasteurized milk
• Do not consume refrigerated pate, meat spreads, or smoked seafood
• Do not consume raw milk

Question 7

Discuss the impact of iron deficiency on the maternal/fetal/neonatal dyad

Answer 7

1. Iron helps form some enzymes necessary for metabolism and is important in the formation of hemoglobin
2. 1000mg of absorbed iron above maternal iron stores is needed in pregnancy
3. Need for increased iron is mostly in the second half of pregnancy
4. 300mg transferred to fetus daily, 200mg daily loss, 500mg for increased maternal production of red blood cells
5. Maternal RBC increase 20-30% during pregnancy
6. Fetal stores of iron double in the last weeks of pregnancy and the infant’s intake of iron is low for the first 4-6 months after birth
7. Iron will be transferred to the fetus even if the mother is anemic (fetus will have less and an increased risk of anemia during the first year)
8. Iron is better absorbed during pregnancy but it cannot be supplied cmpletely by the diet
9. Supplementation begins during the second trimester when need increases and morning sickness has ended
10. High doses require zinc

Question 8

Folic Acid

Answer 8

• During pregnancy 600 mcg
• Most prevalent vitamin deficiency during pregnancy
• Usually supplemented during pregnancy