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Maternal Newborn > Nutrition in Pregnancy > Flashcards

Nutrition in Pregnancy Flashcards

1
Q

Determinants for optimal weight gain

A
  • BMI
  • pre-pregnant nutritional state
  • adequate and balanced caloric intake
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2
Q

Normal BMI during pregnancy

A

18.5-24.9

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3
Q

If a woman is meeting her calories for the day, does this also mean she is meeting her and the baby’s nutritional needs?

A

No!!

Rationale: An adequate caloric intake does no necessarily mean nutritional needs are being met.

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4
Q

How many lbs should an UNDERWEIGHT woman gain during pregnancy?

A

28-40lbs

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5
Q

How many lbs should a NORMAL weight woman gain during pregnancy?

A

25-35lbs

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6
Q

How many lbs should an OVERWEIGHT woman gain during pregnancy?

A

15-25lbs

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7
Q

How many lbs should an OBESE woman gain during pregnancy?

A

11-20lbs

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8
Q

How many lbs should a woman gain during pregnancy if she is carrying twins?

A

35-45lbs

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9
Q

ketonemia

A

losing weight in pregnancy

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10
Q

How many lbs does the fetus, placenta, and amniotic fluid add?

A

12+ lbs

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11
Q

How many lbs does the uterus add?

A

2lbs

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12
Q

How many lbs does increased blood volume add?

A

4+ lbs

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13
Q

How much does the blood volume increase throughout pregnancy?

A

40-50%

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14
Q

How many lbs do the breasts add?

A

1-4lbs

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15
Q

How many lbs do the maternal stores of fluid and ECF fluid add?

A

3-8lbs

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16
Q

How many lbs do the increased fat stores add?

A

4-6lbs

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17
Q

What is considered the “weight to lose” after birth?

A

the increased fat stores

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18
Q

How many lbs/month/overall should be gained in the 1st trimester?

A

1lb/month x3 months = 3lbs

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19
Q

How many lbs/week/overall should be gained in the 2nd and 3rd trimesters?

A

1lb/week x26 weeks = 26lbs

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20
Q

What amount of weight gain is considered “excessive” and is cause for evaluation?

*likely cause??

A

> 2lbs/week or >6.6lbs/month

*r/t fluid retention

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21
Q

Amount of kcalories needed in 1st trimester

A

1800 kcalories

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22
Q

Amount of kcalories needed in 2nd trimester

A

2200 kcalories

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23
Q

Amount of kcalories needed in 3rd trimester

A

2400 kcalories

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24
Q

What can cause excess weight gain in pregnancy?

A

Too much caloric intake in the 1st trimester

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25
Q

True or False:

A majority of women in the United States who give birth are overweight or obese.

A

TRUE

Rationale: 60% of women in the US who give birth are overweight or obese. They are considered “high-risk” pregnancies and are at risk for developing perinatal/maternal conditions.

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26
Q

Risks that coincide with pregnant women who are overweight/obese

A
  • SAB/ miscarriage
  • development of gestational DM
  • HTN/ pre-eclampsia
  • induction of labor
  • c-section
  • thromboembolism
  • abnormal fetal development
  • PPH
  • depression
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27
Q

True or False:

Pregnant women should eat 3 large meals per day just like normal.

A

FALSE.

Rationale: Pregnant women should eat 6 small meals per day. This helps to stabilize blood glucose.

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28
Q

Why is a small snack of protein recommended at bedtime?

A

Helps to keep blood glucose consistent through the night (prevents drops)

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29
Q

How should a plate look for a pregnant woman?

A

Variety of colors ie. greens, browns for meat, red berries, etc.

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30
Q

Recommended supplements during pregnancy

A
  • folic acid (before pregnancy and during)
  • iron (2nd and 3rd trimester)
  • daily prenatal vitamin
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31
Q

Why do pregnant women need supplemental iron?

A

A lot of iron goes to the baby so you need to supplement to decrease risk of anemia.

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32
Q

Reason for needing folic acid during pregnancy

A

Folic acid reduces risk of neural tube defects (NTDs)

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33
Q

Anemia in pregnancy is associated with…

A

preterm labor and SGA infants

34
Q

Sources of iron include…

A
  • lean meat (low fat ratio)
  • dark leafy greens
  • eggs
  • whole grain and enriched cereals/ breads
  • dried fruits
  • legumes
  • prune juice
  • shell fish
35
Q

Which diet puts women at a higher risk for developing anemia r/t low iron intake?

A

vegetarian

Rationale: The iron found in veggies is not as readily absorbed as the iron found in red meat.

36
Q

Which juice helps iron absorption?

A

Orange juice!

Rationale: Vitamin C increases Fe absorption.

37
Q

When is the ideal time to take iron?

A

with food at bedtime

38
Q

True or False:

It is a sign of iron toxicity if your stools are dark green or black.

A

FALSE.

Rationale: It is perfectly normal to have dark green or black stools when taking iron supplements.

39
Q

How much iron should be consumed in the 2nd and 3rd trimesters?

A

27mg

40
Q

What Hct and Hgb levels are considered anemic in a pregnant woman?

A

Hct <33%

Hgb <11

41
Q

What lab helps determine anemia?

A

serum ferritin levels

42
Q

True or False:

Iron that is not bioavailable can increase constipation.

A

TRUE.

Rationale: Iron found in plants and legumes is not bioavailable and can cause constipation. Vegetarian women should speak to their dietician about this matter.

43
Q

True or False:

Vitamin B9 and folic acid are synonymous.

A

TRUE.

44
Q

How much folic acid should a pregnant woman take in (low risk PG)?

A

0.4mg

45
Q

How much folic acid should a pregnant woman take in (high risk PG)?

A

4mg

46
Q

Sources of folic acid include…

A
  • liver
  • chicken
  • turkey
  • beef
  • lamb
  • green veggies
  • peanuts
  • oranges
  • pasta
  • corn
  • eggs
47
Q

Examples of neural tube defects

A
  • spina bifida
  • meningomyelocele
  • anencephaly
48
Q

What vitamin to vegetarians need to supplement?

A
  • vitamin b12
  • vitamin D
  • calcium
49
Q

What is phenylketonuria (PKU)?

A

An inability to covert phenylalanine to tyrosine, which leads to increased phenylalanine level, leading to toxicity in the blood.

50
Q

True or False:

Women will PKU will complain of musty smelling urine.

A

TRUE.

51
Q

Who is at highest risk for developing PKU?

A

Caucasians

52
Q

What food should women with PKU avoid at all cost during pregnancy? Why?

A

food containing aspartame (artificial sweeteners)

the body breaks this down into phenylalanine

53
Q

True or False:

Women can pass PKU onto their babies if not careful.

A

TRUE.

Rationale: Women with PKU should be on a PKU diet to decrease risk of passing condition to baby.

54
Q

True or False:

Babies with PKU can be completely breastfed.

A

FALSE.

Rationale: Babies with PKU need to be fed either completely with phenylalanine-free formula or given a mixture of breastmilk and PAF formula.

55
Q

What is the only FDA approved drug to help with PKU?

A

Kuvan (sapropterin)

Rationale: Increases tolerance to phenylalanine.

56
Q

How much fluid should pregnant women drink daily? How much of this should be water?

A

3 liters

8-10 (2.3L) glasses

57
Q

True or False:

Dehydration increases the risk of cramping, uterine contractions, and PTL.

A

TRUE.

*also decreases amniotic fluid volume

58
Q

Why should pregnant women limit coffee, tea, soft drinks, and energy drinks?

A

These drinks contain caffeine, which causes vasoconstriction of blood vessels and also acts as a diuretic.

59
Q

Why is mercury dangerous in pregnancy?

A

The developing fetal brain is susceptible to the effects of mercury neurotoxicity.

60
Q

Which fish carry high levels of mercury? Limit to…

A
  • shark
  • swordfish
  • king mackerel
  • albacore tuna

Limit to 6oz/week

61
Q

Low levels of mercury are found in which fish? Limit to…

A
  • canned light tuna
  • shrimp
  • salmon
  • catfish
  • pollock
  • sardines
  • trout

Limit to 12oz/week

62
Q

Why is seafood important in pregnancy?

A

Provides a source of omega 3 fatty acids, which improve neurologic/visual development and reduce risk for PTB.

63
Q

If wanting to avoid listeriosis and E. coli, which foods should be restricted?

A
  • cookie dough
  • unpasteurized dairy or juice
  • uncooked seafood
  • store prepped salads with eggs, ham, chicken, or seafood
64
Q

True or False:

Pregnant women do not need to be cautious of hotdogs, lunch meats or prepackages foods.

A

FALSE.

Rationale: It is possible that these foods contain listeriosis and E. coli. These foods should be avoided and hot dogs should be cooked to 160 degrees.

65
Q

If wanting to avoid toxoplasmosis, which foods should be restricted?

A

unpasteurized eggs and undercooked meats

66
Q

True or False:

A pregnant woman should not handle cat feces or the litter box.

A

TRUE.

Rationale: Cat feces can carry toxoplasmosis. The woman should have a friend or family member dispose of the litter.

67
Q

What do listeriosis, E. coli, and toxoplasmosis cause if contracted during pregnancy?

A

Causes maternal and fetal sepsis. Can also cause SAB, PTB, or still birth.

68
Q

How does listeriosis, E. coli, and toxoplasmosis travel to baby?

A

Transplacentally or during birth.

69
Q

True or False:

If a laboring or postpartum mother presents with brown stained amniotic fluid or with an abnormal placenta, this is not cause for concern.

A

FALSE.

Rationale: These two signs are signs of infection (listeriosis, E. coli, toxoplasmosis) and the mother and baby should be tested immediately.

70
Q

Why is PICA severely underreported?

A

embarrassment

71
Q

Which groups are at a higher risk for developing PICA?

A
  • low socioeconomic status
  • African Americans
  • Hispanics
  • rural dwelling
  • family hx of PICA
  • LOW IRON during pregnancy
72
Q

What do African American women with PICA usually crave?

A

cornstarch

73
Q

What do Hispanic women with PICA usually crave?

A

Tierra - eating soil and pulverized pottery

74
Q

Women with PICA are at a higher risk for which two conditions?

A

Anemia and constipation

75
Q

Do adolescents need to gain more or less weight during pregnancy?

A

MORE

76
Q

How many calories should a breast feeding woman eat per day?

A

approx. 500+ kcalories than normal

2500-2700 kcalories

77
Q

How many grams of protein should a breastfeeding mom eat per day?

A

62-65 grams/day

78
Q

What are some foods that make babies colicky?

A

garlic, onions, cabbage, chocolate

79
Q

Should moms continue to take iron postpartum?

A

YES!!! For 2-3 months postpartum

80
Q

How comprehensive should a diet analysis be?

A

very comprehensive - helps get a true evaluation of eating patterns

Maternal Newborn (6 decks)

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