Pregnancy

Question 1

Metabolic and Nutritional Needs

Answer 1

BMR increases ~15%
Need extra calories
Need “placental stores” to sustain fetal growth

Question 2

Respiratory Rate

Answer 2

Increases
20% increased oxygen used by mom at term
Progesterone increases minute ventilation
Uterus presses against diaphragm - harder to breathe

Question 3

Circulatory

Answer 3

Increase in plasma volume → primarily water (30-50%)
Increase in red blood cells → less than plasma - less than 10%
Results in overall decrease in hematocrit

Question 4

Kidney Function

Answer 4

Increase in GFR → important for medicine processing

Decrease in systemic vascular resistance → compensating for increased plasma

Question 5

Breasts

Answer 5

Milk ducts → increasing and filling

Tenderness and soreness first signs of pregnancy

Question 6

Folic Acid

Answer 6

Function: cell division, DNA synthesis, neurodevelopment

Dose: decrease NTD risk, 400-800 mcg daily

Adverse Effects: water soluble, may mask B12 deficiency

Question 7

Iron

Answer 7

Function: Hb, myoglobin, transferrin, ferritin, loss largely due to blood loss, iron deficiency anemia, needed for RBC production

Dose: determined by Hb and iron status prior

Adverse effects: constipation, nausea, bloating, overdose fatal!!

Question 8

Calcium

Answer 8

Function: bone, neuro excitability, muscle contraction, cardiac, blood coagulation, fetal skeletal development, maternal skeletal, maybe prevent preeclampsia

RDA-Pregnancy: 1000 mg elemental Ca/day – includes food intake

Adverse effects: mostly GI, constipation