4.1c Other Nutritional Issues During Pregnancy, Nutritional Care, Teaching Flashcards Preview

OB > 4.1c Other Nutritional Issues During Pregnancy, Nutritional Care, Teaching > Flashcards

Flashcards in 4.1c Other Nutritional Issues During Pregnancy, Nutritional Care, Teaching Deck (25)
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1
Q

Alcohol

A
  • No safe amount at any point in pregnancy
  • Teratogen causes the below
    Birth defects
    Impaired cognitive and psychomotor development
    Emotional and behavioral problems
    Growth restriction
    CNS abnormalities
    Facial dysmorphia
2
Q

Caffeine

A
  • Less than 200 mg daily has been shown to be safe
3
Q

Artificial Sweeteners

A
  • Aspartame should be avoided in patients with PKU
  • PKU (Amino acid phenylalanine build up in body which results in health problems)
  • DO NOT TAKE STEVIA (plant based sweetener)
  • Nutrasweet, Sunett, Splenda are okay to take
4
Q

PICA

A
  • Consuming non-food substances or excessive amount of low nutrition food
  • Often influenced by cultural background
  • Screening during first prenatal visit, every trimester, and if anemia is present
5
Q

Food Cravings

A
  • Generally not harmful to satisfy cravings
6
Q

Types of vegetarianism

A

Lacto-Vegetarian - Consumes milk products
Lacto-Ovo Vegetarians - Consumes egg, dairy, plants
Vegans - Consumes only plant products

Vegetarians can obtain adequate nutrition for pregnancy
Vegans should be referred to nutritional counseling

7
Q

Gluten Free Diets

A
  • Little to no evidence of gluten free benefits
8
Q

Nutritional Assessment

A
  • Preformed before conception to recommend diet, lifestyle, weight changes before pregnancy
  • Completed at first prenatal visit
9
Q

Health History

A
  • Completed at first prenatal visit and provides nutrition needs and concerns
  • Nutrition can be affected by DM, liver disease, cystic fibrosis, crohns disorder
  • Adolescents and multiple gestations should be referred to nutrition counseling
  • Bariatric surgery also has serious implications for nutritional health
10
Q

How to preform Nutrition Health Assessment

A
  • Bariatric surgery has serious implications for nutritional health during pregnancy
  • Information about medication, alcohol, tobacco, drugs
  • Review of OB and gynecologic history may reveal nutritional concerns
  • Important to note if pregnant woman is an adolescent
  • Adolescent and multiple gestations are both important to note
11
Q

Nutritional Assessment Components

A
  • Adequate income to support nutritional needs
  • Dietary modifications
  • Food allergies/intolerances
  • All medication and supplements
  • Unusual cravings, PICA, cultural dietary practices
  • Presence of n/v, constipation, pyrosis (heartburn)
  • Evidence of eating disorders (anorexia, bulimia, rigorous dieting)
12
Q

Anthropometric (Body) Measures

A
  • Physical Assessment
  • Height and weight during first prenatal visit
  • Weight measured at each subsequent prenatal visit
  • BMI determines how much weight should be gained
13
Q

Laboratory Testing

A

ONLY IMPORTANT ONES

- Hematocrit & hemoglobin

14
Q

Education

A
  • Nutritional needs during pregnancy
  • Appropriate weight gain throughout pregnancy
  • Dietary planning
  • Coping methods for nutrition related discomforts
  • Appropriate use of supplements
  • Avoid alcohol/tobacco/drugs
  • Safe food preparation and handling
15
Q

Financial Programs

A
  • Supplement Nutrition Assistance Program (SNAP)

- Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

16
Q

Nutrition Risks

A
  • LBW
  • Preterm Birth
  • First trimester crucial for neural tube defect
17
Q

Weight Gain during Pregnancy

A

First Trimester
- Total weight gain 1-2 kg

Second & Third Trimester
Underweight - 0.5kg per week
Normal - 0.4kg per week 
Overweight - 0.3kg per week
Obese - 0.2kg per week
18
Q

Helpful Teaching Strategies of Diet Planning

A
  • Daily food guide is good education for most cultures and vegetarians
  • Helpful strategy is to help patients plan daily menus that are affordable and have realistic preparation times
19
Q

Food Safety

A
  • Impacts fetus possibly due to
  • Ecoli
  • Salmonella
  • Listeriosis
  • Toxoplasmosis
  • Brucellosis
20
Q

HOW TO COPE

A
21
Q

Nausea and Vomiting

A
  • Antiemetic Medications
  • Vitamin B6
  • Ginger
  • Acupuncture
    HYPERMESIS GRAVIDARUM (EXTREME VOMITING)
  • Causes weight loss, dehydration, electrolyte abnormalities
  • Cure includes IV fluid replacement, electrolyte replacement, enteral tube feeding, TPN
22
Q

Constipation

A
  • Increased fiber
  • Adequate fluid intake 8-10 cups a day
  • Regular Physical Activity
23
Q

Pyrosis

A
  • Caused by reflux of gastric contents
  • Eat small more frequent meals
  • Do not consume fluid with food (drink in between meals)
  • Avoid spicy foods
  • Avoid lying down directly after eating
  • Avoid wearing tight clothes around abdomen
24
Q

Adolescent Pregnancy

A
  • Cephalopelvic disproportion (baby head too big for moms pelvis) is common
  • Competition for nutrients from baby and mother
  • Mom generally needs more nutrients in adolescent pregnancy
25
Q

Bariatric Pregnancy

A
Common Deficiencies
- Folate
- B12
- Iron (Iron deficiency long term effect after bariatric surgery) 
- Calcium 
- Vitamin D
Screen for nutrient deficiencies, appropriate weight gain, provide supplemental nutrition 
Risks
- Prematurity
- Small for gestational age
- NICU admission

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