Lectures 52/53

Question 1

increase in prenatal diet

Answer 1

300 to 400 extra calories per day
folate and folic acid
calcium
vitamin D
protein

Question 2

benefits of adding folic acid in prenatal diet

Answer 2

helps prevent neural tube defects of brain and spinal cord
supports growth and development

Question 3

benefit of increasing calcium intake in prenatal diet

Answer 3

builds strong bones and teeth

Question 4

benefits of increasing vit d intake in prenatal diet

Answer 4

promotes healthy skin and eyesight
helps with bone and teeth development

Question 5

decrease in prenatal diet

Answer 5

artificial sweeteners
unpasteurized foods
alcohol
unwashed fruits and vegetables
herbal teas
undercooked meat, poultry, or eggs
caffeine (takes longer for the body to metabolize, limit to <200mg/day)

Question 6

when would a pt start their prenatal diet?

Answer 6

ideally 3 months prior to conception
folic acid should be initiated at least 1 month before trying to get pregnant
no recommendation on how long after postnatal period to continue

Question 7

vaccination recommendations during pregnancy

Answer 7

inactivated influenza (during flu season)
tdap (weeks 27-36 optimally)
rsv (weeks 32-36 during sept to jan or baby under 8mo)
covid-19 (stay up to date)

Question 8

vaccinations to avoid in pregnancy

Answer 8

HPV
MMR
live influenza (nasal)
varicella
yellow/typhoid fever

Question 9

alcohol usage in pregnancy/lactation

Answer 9

not recommended can cause fetal alcohol syndrome (CNS abnormalities, growth defects, facial dysmorphia) and other birth defects (growth deformities, CNS impairment, behavior disorders, impaired intellectual development)

Question 10

tobacco usage in pregnancy/lactation

Answer 10

increases risk of preterm birth, low birth weight, birth defects, and SIDs
allow tobacco free period before contraception

Question 11

marijuana usage in pregnancy/lactation

Answer 11

increases risk of low birth weight, brain development disruption, decreased attention span, behavioral problems, marijuana use in child by age 14

Question 12

opioids usage in pregnancy/lactation

Answer 12

exposure can cause poor outcomes for both mother and baby –> maternal death, poor fetal growth, preterm birth, stillbirth, neonatal opioid withdrawal syndrome

Question 13

how would you treat someone with a substance use disorder during pregnancy?

Answer 13

with methadone or buprenorphine

Question 14

first line treatment for pregnancy-induced nausea and vomiting

Answer 14

non-pharmacologic options
avoid triggers (foods, smells, motion)
drink throughout the day
eat smaller, frequent, dry meals
eat dry toast or crackers before getting out of bed
avoid spicy foods
keep stomach from being completely empty

Question 15

second line treatment for pregnancy-induced nausea and vomiting

Answer 15

pharmacologic options
pyridoxine (vit b6)
doxylamine and pyridoxine
meclizine, dimenhydrinate, diphenhydramine
last line - ondansetron, metoclopramide

Question 16

non-pharm treatment for pregnancy-induced heartburn/gerd

Answer 16

smaller, more frequent meals
eat slowly
avoid food and drinks 3 hours before bed
elevate head of the bed
avoid smoking and alcohol use

Question 17

pharm treatment for pregnancy-induced heartburn/gerd

Answer 17

1st line - antacids (magnesium hydroxide, calcium carbonate)
sucralfate (not absorbed in GI tract)
histamine-2 receptor antagonists, proton pump inhibitors

Question 18

non-pharm treatments to pregnancy-induced constipation

Answer 18

eat 25 to 30g of fiber rich foods each day
increase fluid intake to 9 to 12 glasses of water per day
get 20 to 30 minutes of moderate exercise 3 times a week

Question 19

pharm treatments of pregnancy-induced constipation

Answer 19

fiber (psyllium, calcium polycarbophil)
osmotic laxatives (PEG and lactulose)
stool softeners (docusate)
bulk laxatives (psyllium)
AVOID – castor oil/mineral oil

Question 20

non-pharm treatment for pregnancy-induced pain, fever, and headache

Answer 20

cool compress
manage stress
increase relaxation techniques
get at least 8 hours of sleep each night

Question 21

pharm treatment of pregnancy-induced pain, fever, and headaches

Answer 21

1st line – acetaminophen
AVOID – NSAIDs and aspirin

Question 22

treatment of cough and cold while pregnant

Answer 22

1st line – cromolyn
2nd line – chlorpheniramine, diphenhydramine
lorate and ceritrize can be used during 2/3rd trimesters (be avoided in 1st)

Question 23

treatment of UTIs during pregnancy

Answer 23

cephalexin
nitrofurantoin and sulfamethoxazole with trimethoprim
amoxicillin and amox-clav (high degree of resistance)
fosfomycin and nitrofurantoin (Avoid with pyelonephritis)

Question 24

treatments to AVOID in UTIs during pregnancy

Answer 24

fluoroquinolones (floxacins)
tetracyclines (cyclines)
sulfamethoxazole with trimethoprim (mixed data)