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PT: Nutrition Exam 1 > Pregnancy & Lactation > Flashcards

Pregnancy & Lactation Flashcards

1
Q

Metabolic influences during early pregnancy

A
  • increased glycogen storage
  • increased glucose utilization
  • increased insulin response to glucose
  • hypoglycemia can be a problem in pregnancies complicated by diabetes
  • hyperemesis & food intolerance related to HCG
  • increased nutrient absorption
  • increased fat deposition
  • increase of blood volume (2nd trimester)
  • elevation of basal metabolic rate
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2
Q

Metabolic influences during late gestation

A
  • increased insulin resistance related to HPL & estrogen
  • accelerated growth of fetus
  • more rapid diversion to fat metabolism in fasting state (accelerated starvation)
  • higher free FA & ketone production (increased DKA)
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3
Q

Assessing preconception nutrition status in pregnancy

A
  • identify women at nutritional risk
  • preconception history
  • provide appropriate nutrition intervention
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4
Q

What should the preconception history in pregnant women include?

A

Weight status
Dietary practices
Use of harmful substances

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5
Q

Weight gain during pregnancy

A
  • birth weight is influenced by mothers PREPREGNANCY weight & overall weight gain
  • base recommendations for weight gain on prepregnancy BMI
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6
Q

Why is weight gain important during pregnancy?

A
  • influences fetal growth & length of gestation

- inadequate weight gain is associated with increased prematurity rate & LBW

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7
Q

What is a major determinant for infant mortality and morbidity?

A

LBW

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8
Q

LBW is related to an increased risk of what?

A
  • CVD
  • DM
  • HTN
  • obesity later in life
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9
Q

BMI <18.5; what is the recommended weight gain during pregnancy?

A

28 - 40 lbs

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10
Q

BMI 18.5 - 24.9; what is the recommended weight gain during pregnancy?

A

25 - 35 lb

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11
Q

BMI 25 - 29.9; what is the recommended weight gain during pregnancy?

A

15 - 25 lb

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12
Q

BMI >30; what is the recommended weight gain during pregnancy?

A

11 - 20 lb

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13
Q

What is the recommended weight gain with twin pregnancies?

A

25 - 45 lb

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14
Q

What is the recommended weight gain for someone having triplets?

A

Overall gain of 50 lb

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15
Q

What can excessive maternal weight lead to?

A
  • gestational diabetes, HTN, T2D

- risk of fetal macrosomia, shoulder dystocia, childhood obesity

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16
Q

What increases the risk of neural tube defects independently of ____ intakes?

A

Obesity; folate

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17
Q

Bringing weight into a healthy range before pregnancy can help with what?

A
  • conception easier
  • improves pregnancy outcomes
  • may enhance lactation productivity
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18
Q

What are energy needs during the 2nd and 3rd trimester?

A

Additional 100 - 300kcal/day in older adults

500kcal/day in young adolescents (<14)

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19
Q

What are the protein needs during pregnancy?

A

Additional 10-13g

Approx 71g/day

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20
Q

Calculating needs for pregnancy

A
  • consult RD and pharmacy for TPN

- Use basal energy expenditure x 1.4 activity factor (BEE)

21
Q

RDA for folic acid in pregnancy

A

600mcg during pregnancy

500mcg during lactation

22
Q

Folic acid prepregnancy

A

400mcg recommended supplementation to prevent neural tube defects

23
Q

T/F insulin dependent diabetes in high risk pregnancy need a lower than average amount of folic acid

A

False!

Much higher!!

24
Q

Vegans and folic acid

A

Should also take B12

- low folate and B12 are independent risk factors for neural tube defects

25
Q

Foods rich in folate

A
  • legumes
  • green leafy veggies
  • liver
  • citrus fruits
  • whole wheat bread
  • fortified foods and supplements
26
Q

Iron in pregnancy

A
  • increased in 2nd and 3rd trimester (27mg)

- lower during lactation (10)

27
Q

Food sources of iron

A

Lean red meat, fish, poultry, dried fruits, iron fortified cereals

28
Q

Calcium during pregnancy

A

1300mg age 14-18
1000mg age 19-50

3-4 servings per day

29
Q

Vitamin D during pregnancy

A
  • Important for fetal development
  • can prevent congenital rickets
  • predictor of infant size
30
Q

Choline during pregnancy

A
  • key role in fetal brain development

- influences neurotransmission with effects on brain, heart, muscle, GI tract

31
Q

Foods to enhance choline

A
  • eggs, beef steak, salmon, lean ground beef, green leafy veggies. Low fat milk
32
Q

Mega doses of which vitamin during early pregnancy can cause birth defects?

A

Vitamin A

33
Q

Sodium in pregnancy

A

No restrictions unless on low sodium diet

34
Q

Caffeine and pregnancy

A
  • crosses placenta
  • can affect fetal HR and breathing
  • may increase risk of spontaneous abortion and low birth weight
    <300mg/day
35
Q

Alcohol and pregnancy

A

No safe level established at any stage

36
Q

Tobacco/drugs and pregnancy

A
  • limits oxygen supply to fetus

- related to LBW, increase preterm delivery and perinatal mortality

37
Q

Artificial sweeteners and pregnancy

A
  • recognized as safe

- does not cross placenta (only saccharin)

38
Q

Mercury and pregnancy

A
  • can damage nervous system, lungs, kidneys, vision and hearing
  • avoid high mercury!

12oz/week of light tuna and other fish

39
Q

Listeria and pregnancy

A
  • serious bacterial infection
  • may result in stillbirth, septicemia, meningitis
  • avoid feta, blue cheese, lunch meat, smoked seafood, raw cheese

Sources must be cooked!!!

40
Q

Healthy eating during pregnancy

A
  • choose variety of foods
  • low fat/low saturated fat
  • increase grains, fruits, veggies
  • moderate use of sweets, sugars and soft drinks
  • salt as directed
  • 30 min moderate activity most days
41
Q

N/V in pregnancy

A
  • consume small meals frequently
  • avoid offensive odors
  • drink enough fluids
  • get adequate fresh air
  • crackers (higher CHO)
42
Q

Heartburn and pregnancy

A
  • result of slowing movement of food through GI tract
  • avoid laying down after eating
  • sleep with head slightly elevated
  • consume small frequent meals
  • avoid known irritants (caffeine, chocolate, seasoned foods)
43
Q

Constipation and pregnancy

A
  • may be due to high doses of iron or part of normal digestive changes
  • more high fiber
  • increase fluids
  • regular exercise
44
Q

Food cravings, aversions and pica and pregnancy

A
  • common

- be alert to abnormal cravings for non-food items and food items

45
Q

Complications of diabetes in early pregnancy

A
  • Risk for pre-gestational diabetes only

- congenital abnormalities and spontaneous abortion

46
Q

Complications of diabetes later in pregnancy

A
  • hypoglycemia in neonate
  • macrosomia
  • stillbirth
  • RDS
  • increase rate of obesity and diabetes
  • hypocalcemia, hyperbilirubinemia, polycythemia
47
Q

Insulin and pregnancy

A

Give during even if they weren’t on insulin before pregnancy!

48
Q

Nutrition guidelines for diabetes

A
  • match insulin to food
  • consistent CHO vs CHO to insulin ratio
  • 3 meals/day with snacks
  • bedtime snack to prevent ketosis
49
Q

Treatment of diabetes during pregnancy

A
  • appropriate prenatal nutrition
  • adequate prenatal weight gain
  • maintenance of normal blood sugars
  • prevent frequent hypoglycemia
  • manage diabetes related complications

PT: Nutrition Exam 1 (12 decks)

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