Nutrition/General Health in Pregnancy Flashcards

1
Q

Is there a PSA Self-Care Card providing advice around nutrition and general health in pregnancy?

A

Yes (Pregnancy and Ovulation)

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2
Q

What is the preferred supplement for pregnancy?

A

Elevit (Folic Acid 800 mcg, Ferrous Fumarate 60mg, Iodine 220 mcg)

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3
Q

What are the directions for Elevit (Folic Acid 800 mcg, Ferrous Fumarate 60mg, Iodine 220 mcg)?

A

Starting at least 4 weeks prior to conception, take 1 tablet ONCE daily whilst trying to conceive, throughout pregnancy and into breastfeeding.

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4
Q

What are 12 foods to avoid in pregnancy?

A
  1. Soft cheeses for example, Brie, Camembert, Ricotta to Listeria
  2. Cold meats for example, From Delis/supermarkets - Listeria
  3. Uncooked or smoked seafoods and shellfish to Mercury, Listeria, Salmonella
  4. Precooked or prepared cold foods for example, salads, deli meats
  5. Dried/fermented sausages for example, salami
  6. Soft-serve ice cream
  7. Pate
  8. Raw meat, eggs to Salmonella
  9. Caffeine to safe in moderation
  10. Alcohol
  11. Unwashed vegetables to Toxoplasmosis
  12. High sources of vitamin A
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5
Q

What is the recommended diet in pregnancy?

A

Eat a well-balanced and healthy diet including fruit, vegetables, grains, fats, protein etc.

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6
Q

Describe the risk of listeria in pregnancy.

A

Listeria is a bacteria found in some foods. In pregnancy listeria can cause miscarriage, stillbirth or premature labour.

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7
Q

What are 4 early signs of listeria?

A
  1. Fever
  2. flu-like symptoms
  3. muscle aches
  4. general malaise
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8
Q

What is the benefit of taking folic acid supplements for pregnancy?

A

Folic acid taken daily at least 4 weeks before trying to conceive may reduce the risk of neural tube defects, such as spina bifida.

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9
Q

What is the benefit of taking iron supplements for pregnancy?

A

Iron supplementation will help to prevent iron deficiency.

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10
Q

What is the benefit of taking iodine supplements for pregnancy?

A

Iodine can assist in the development of the baby’s brain.

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11
Q

Describe the incidence of muscle cramps in legs in pregnancy.

A

They are common later in pregnancy due to electrolyte imbalances

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12
Q

Do leg cramps in pregnancy require a counselling room?

A

No

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13
Q

Do leg cramps in pregnancy have a PSA self-care card?

A

Yes (pregnancy and ovulation)

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14
Q

What is the preferred treatment option for leg cramps in pregnancy?

A

The mainstay of treatment is non-pharmacological. There is minimal evidence for treatment with Magnesium, Calcium, Vitamin B or Vitamin C.

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15
Q

What are 6 pieces of non-pharmacological advice for leg cramps in pregnancy?

A
  1. Stretching exercises
  2. If a cramp occurs, toe raises can be done as soon as the cramp begins as well as walking and leg elevation
  3. Hot showers/baths
  4. Ice massage
  5. Regular exercise
  6. Adequate hydration
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16
Q

What are the symptoms of pruritis in pregnancy?

A

Itchiness developing from the third month of pregnancy onwards.

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17
Q

Does pruritis in pregnancy require a counselling room?

A

No

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18
Q

Does pruritis in pregnancy have a PSA self-care card?

A

Yes (Pregnancy and ovulation)

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19
Q

What is the preferred treatment option for pruritis in pregnancy?

A

Hydrocortisone 1% Cream (Dermaid)

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20
Q

What are the directions for Hydrocortisone 1% Cream (Dermaid) in pruritis in pregnancy?

A

Apply to the affected area(s) 1 to 2 times daily for up to 7 days

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21
Q

What are 3 non-preferred options for pruritis in pregnancy and why?

A
  1. Shower oils/soap substitutes: less efficacy
  2. Moisturisers: less efficacy
  3. Sedating antihistamines: sedating, systemic side effects
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22
Q

Is Hydrocortisone 1% Cream (Dermaid) safe in pregnancy?

A

Yes

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23
Q

Is Hydrocortisone 1% Cream (Dermaid) safe in breastfeeding?

A

Yes

24
Q

What is the age range for Hydrocortisone 1% Cream (Dermaid)?

A

Safe in children over 2 years

25
Q

What are the symptoms of morning sickness?

A

Persistent vomiting in a pregnant woman that interferes with fluid and electrolyte balance, as well as nutrition.

26
Q

When does morning sickness usually occur?

A

Morning sickness is particularly bad in first trimester and effects 70- 80% of women. Symptoms usually begin around 2 weeks after first missed period.

27
Q

Does morning sickness require a counselling room?

A

Yes

28
Q

Does morning sickness have a PSA self-care card?

A

Yes (Pregnancy and ovulation)

29
Q

What is the preferred treatment option for morning sickness?

A

Ginger 500mg (TravaCalm Natural)

30
Q

What are the directions for Ginger 500mg (TravaCalm Natural) in morning sickness?

A

1 to 2 tablets daily as required to a maximum of 1g daily in pregnancy due to increased risk of blood coagulation.

31
Q

Is Ginger 500mg (TravaCalm Natural) safe in pregnancy?

A

Yes

32
Q

Is Ginger 500mg (TravaCalm Natural) safe in breastfeeding?

A

Yes

33
Q

What is the age range for Ginger 500mg (TravaCalm Natural)?

A

Safe in children over 8 years

34
Q

What are 11 pieces of non-pharmacological advice for morning sickness?

A
  1. Eat small frequent meals (4 to 6 daily) to maintain blood sugar levels- don’t wait until you are hungry
  2. Eat a diet high in carbohydrates and protein (fruit, cheese, eggs, beef, poultry, vegetables, toast, rice) and low in fat
  3. Avoid large meals and greasy, highly spicy meals
  4. Drink plenty of water and fruit juices but avoid alcohol and large quantities of tea, coffee or milk
  5. Drink liquids between rather than with meals to avoid bloating which can trigger vomiting
  6. Slowly sip a fizzy drink when feeling nauseated, or eat ice chips
  7. Ginger or peppermint tea may be helpful
  8. Keep rooms well ventilated and odour free
  9. Relax, rest and get into the fresh air as much as possible
  10. Monitor mum for symptoms of dehydration (for example, rapid pulse, low BP, sunken eyelids, reduced skin turgor, cool skin, deep/ increased respirations).
  11. Can recommend a rehydration solution if patients feels they can tolerate fluids.
35
Q

What are 5 symptoms of breast and nipple thrush?

A
  1. Bright pink nipple; the areola may be reddened, dry, flaky or shiny
  2. Fine white rash may be seen on the affected nipple(s)
  3. Pain includes burning, itching, or stinging and may be mild to severe
  4. Nipples may be tender to touch and even light clothing can cause pain
  5. Pain is often experienced immediately after and between feeds
36
Q

Does breast and nipple thrush require a counselling room?

A

Yes

37
Q

Does breast and nipple thrush have a PSA self-care card?

A

Yes (Pregnancy and Ovulation)

38
Q

What is the preferred treatment option for breast and nipple thrush?

A

Clotrimazole 1% Cream (Canesten)

39
Q

What are the directions for Clotrimazole 1% Cream (Canesten) in breast and nipple thrush?

A

Adult and Children over 2 years: Apply to the affected area 2-3 times daily. Continue treatment for 2 weeks after symptoms disappear to avoid recurrence.

40
Q

What are 2 non-preferred options for breast and nipple thrush and why?

A
  1. Topical terbinafine: less safety in young children
  2. Oral fluconazole: systemic effects, drug-drug interactions
41
Q

Is Clotrimazole 1% Cream (Canesten) safe in pregnancy?

A

Yes

42
Q

Is Clotrimazole 1% Cream (Canesten) safe in breastfeeding?

A

Yes

43
Q

What is the age range for Clotrimazole 1% Cream (Canesten)?

A

Safe in children over 2 years

44
Q

What are 4 pieces of non-pharmacological advice for breast and nipple thrush?

A
  1. Keep nipples dry by frequently changing breast pads as thrush grows well in a moist and warm environment.
  2. Clean teats and dummies thoroughly after use and boil for five minutes (replace weekly if possible).
  3. Wash hands thoroughly after nappy changes and before and after applying any creams/lotions.
  4. Wash towels, bras, cloth nursing pads etc. in hot soapy water and air dry outside (sunlight).
45
Q

How does breast and nipple thrush commonly present?

A

It commonly presents as nipple pain without any apparent cause

46
Q

What are 4 possible contributing factors to breast and nipple thrush?

A
  1. Women with history of vaginal thrush
  2. Infants with a history of thrush or nappy rash
  3. Recent course of antibiotics
  4. Nipple damage (slow to heal)
47
Q

What are 6 symptoms of mastitis?

A
  1. Flu like symptoms
  2. Fever (>38˚C)
  3. Body aches and pain (particularly at joints or muscle)
  4. Feeling hot and cold
  5. Red, sore, tender/swollen area on breast(s)
  6. Skin may look shiny with red streaks
48
Q

Does mastitis require a counselling room?

A

Yes

49
Q

Does mastitis have a PSA self-care card?

A

No

50
Q

What is the preferred treatment option for mastitis?

A

Referral to a doctor is commonly required for course of Antibiotics. Simple analgesia (Paracetamol) is indicated in the interim to assist with pain and associated fever.

51
Q

What are the directions for paracetamol in mastitis?

A

15 mg/kg (up to 1,000 mg) every FOUR to SIX hours. Maximum of 60 mg/kg (up to 4,000 mg) in 24 hours.

52
Q

Is paracetamol safe in pregnancy?

A

Yes

53
Q

Is paracetamol safe in breastfeeding?

A

Yes

54
Q

What is the age range for paracetamol?

A

Safe in children over 1 month

55
Q

What are 10 pieces of non-pharmacological advice for mastitis?

A
  1. Breastfeeding or expressing milk (manually or via a pump) from the infected breast is safe and should be continued
  2. In patients without systemic symptoms, increased breastfeeding and gently expressing milk from the affected breast may prevent progression and resolve infection without antibiotics
  3. Gently massage any breast lumps towards the nipple when feeding or expressing or when in the shower or bath
  4. Place a heat pack or warm cloth’s on the sore area before feeding or expressing to help with milk flow if needed
  5. Place a cool pack wrapped in a cloth, on the breast after feeding or expressing for a few minutes to reduce discomfort
  6. Position infant optimally
  7. Breastfeed as often as the baby needs (normally 8 to 12 times in 24 hours for a new baby)
  8. Don’t miss or put off breastfeeds - wake the baby for a feed if breasts become too full (or will need to express)
  9. Express a small amount of milk after feeds if patient’s breasts still feel full to express only until breasts feel comfortable
  10. Avoid pressure on your breasts from clothes or from your fingers when feeding
56
Q

When is mastitis most common?

A

Mastitis occurs most commonly in the first six weeks after delivery