Pregnancy Conditions and Interventions

Question 1

obesity can increase the risk of a child developing ______ later in life

Answer 1

overweight/obesity
type 2 diabetes

Question 2

pregnancy after bariatric surgery should be avoided for _____ due to ______

Answer 2

several years
nutrient deficencies

Question 3

interventions for pregnancy after bariatric surgery ?

Answer 3

assessment of dietary intake, supplement use, and measurements of nutrient stores at every trimester

Question 4

hypertensive disorders of pregnancy

Answer 4

chronic hypertension
preeclampsia-eclampsia
gestational hypertension

Question 5

hypertensive disorders affect ____% of pregnancies

Answer 5

5-10%

Question 6

Hypertension in pregnancy is related to _______

Answer 6

inflammation
oxidative stress
damage to endothelium of blood vessels

Question 7

consequences of damage to endothelium

Answer 7

restriction of placental blood flow
increased tendency to clot
atherosclerotic plaque formation

Question 8

chronic hypertension is when it doesn’t go away after pregnancy or was there before and is defined as systolic BP of ____ and diastolic BP of _____

Answer 8

systolic ≥140 mm Hm
diastolic ≥90mm Hm

Question 9

____% of women will develop preeclampsia

Answer 9

20%

Question 10

nutrition interventions for chronic hypertension

Answer 10

if sodium reduction helps before you can stay with that as long as u don’t go under 1500 mg

do not go low sodium if u weren’t already, it is not proven to help during pregnancy

Question 11

What is preeclampsia

Answer 11

after 20 weeks gestation
increased blood pressure (140/90 or above)
proteinuria (more than .3 g protein excreted in 24 hrs)

Question 12

what is eclampsia

Answer 12

seizures late in pregnancy in a women with preeclampsia

Question 13

preeclampsia affects __________ with blood vessel spasms and constriction of blood flow, insulin resistance, high TG and FFA

Answer 13

placenta
maternal kidney
baby liver
baby brain

Question 14

signs and symptoms of preeclampsia

Answer 14

hypertension
proteinuria
low urine output
sever and persistant headache
sensitive to light
abdominal pain
nausea

Question 15

cause of preeclampsia

Answer 15

unknown but think it originates from abnormal implantation of placenta

Question 16

cure to preeclampsia

Answer 16

deliver the baby

Question 17

nutrition interventions for preeclampsia

Answer 17

1000-2000 mg/day of dietary or supplemental calcium

adequate fiber, fruits, and veggies

avoid high dose iron supplements

moderate exercise

Question 18

what is gestational hypertension

Answer 18

hypertension diagnosed after 20 weeks of pregnancy

NO proteinuria

Question 19

what is gestational diabetes

Answer 19

diabetes diagnosed in pregnancy that is clearly not chronic diabetes

high maternal BG = increased fetal BG = more fetal insulin production = increases glucose uptake and TG formation in fetus

Question 20

outcomes associated with gestational DM in mother

Answer 20

increased risk for type 2 diabetes, hypertension, and obesity later in life

increased risk for gestational DM in next pregnancies

Question 21

outcomes in baby associated with gestational DM

Answer 21

macrosomia (weigh more than 10 lb)

neonatal hypoglycemia

increased risk of insulin resistance, type 2 DM, HTN, and obesity later In life

Question 22

how do they test for gestational diabetes

Answer 22

between 24-28 weeks, all pregnant women are given a 75 gram, 2 hr oral glucose tolerance test (OGTT)

Question 23

after first test for GDM if one of the plasma glucose values exceeds these, you have to come in for another test, and if it does it again they diagnose you. what are the values?

Answer 23

fasting ≥92 mg/dl
1 hr ≥180 mg/dl
2hr ≥153 mg/dl

Question 24

how do they manage gestational diabetes

Answer 24

first with diet and exercise

if that doesn’t work in the 2 weeks after, they will add insulin injections

Question 25

nutrition recommendations for GDM

Answer 25

- 3 regular meals and several snacks including bedtime snack - whole grain breads, cereals, veggies, fruits, high fiber foods - limit intake of simple sugars - emphasis on unsaturated fats - foods with low glycemic index

Question 26

monitoring of gestational diabetes invloves _____

Answer 26

urinary ketone testing postpartum follow up bc 10-15% develop type 2 within 2-5 yrs

Question 27

women who have GDM should have screening every ____ years and may take lifestyle interventions and ______ to prevent DM

Answer 27

3 years metaformin

Question 28

mother with type 1 diabetes is at risk of

Answer 28

kidney disease HTN preeclampsia

Question 29

newborn of other with diabetes type 1 have risk for ________

Answer 29

hypoglycemia at birth LGA or SGA preterm delivery congenital malformations mortality

Question 30

interventions for type 2 diabetics getting pregnant

Answer 30

replace DM medications with insulin before conception maintain BG levels

Question 31

risks associated with type 2 diabetes in pregnancy

Answer 31

maternal hypoglycemia - miscarriage - congenital anomalies hyperglycemia - high blood ketone levels (blood glucose >200 mg/dl) - diabetic ketoacidosis, which can decrease intelligence or increase fetal mortality

Question 32

dizygotic twins

Answer 32

fraternal 2 eggs are fertilized 70% of twins different DNA (genetic "fingerprints") hereditary

Question 33

monozygotic twins

Answer 33

identical 1 egg fertilized and splits 30% of twins always same sex same DNA not influenced by heredity

Question 34

in twin pregnancy how much should normal, overweight, and obese women gain

Answer 34

normal: 37-54 lb overweight: 31-50 lb obese: 25-42 lb

Question 35

rate of weight gain in twin pregnancy

Answer 35

5-7 lb in 1st trimester 1-2 lb per week in 2nd and 3rd trimesters

Question 36

weight gain in triplet pregnancy

Answer 36

50 lb result in healthy sized triplets 1.5 lb per week from beginning of pregnancy

Question 37

for twin pregnancy increase calories by _____

Answer 37

450

Question 38

what is hyperemesis gravidarum

Answer 38

severe nausea and vomitting during much of pregnancy

Question 39

____% of women have hyperemesis gravidarum

Answer 39

1-2%

Question 40

risks in hyperemesis gravidarum

Answer 40

dehydration ekectrolyte imbalances inadequate weight gain ketosis - small infants

Question 41

treatment goals of hyperemesis gravidarum

Answer 41

adequate weight gain and preventing hospitalization

Question 42

management of hyperemesis gravidarum

Answer 42

6 small meals/snacks during the day hydration with water or caffeine-free beverages ginger or gingerale limit high fat foods, which worsen naesua easy to digest foods

Question 43

treatment of HIV and AIDS in pregnancy

Answer 43

needed before, during, and after pregnancy to try not to pass on to baby

Question 44

goals in pregnant women with HIV/AIDS

Answer 44

educate on food safety maintain positive nitrogen balance and preservation of lean muscle and bone mass

Question 45

______ is the most common ED seen in pregnant women in the US

Answer 45

bulimia

Question 46

eating disorder symptoms in pregnancy

Answer 46

subside in 2nd and 3rd trimester but return postpartum

Question 47

nutritional interventions for pregnancies with eating disorders

Answer 47

weight gain improve nutritional status educate on needed behavioral changes and rationale of "for the baby"

Question 48

alcohol disorders include....

Answer 48

alcohol-related developmental disorder alcohol-related birth defects fetal alcohol syndrome

Question 49

alcohol easilt passes across the placenta to the fetus and stays in feal circulation longer bc ______

Answer 49

they dont have the enzymes to metabolize it

Question 50

most severe form of FASD is characterized by

Answer 50

- abnormal facial features - growth problems - intellectual disability - flat midface - upturned nose - small eyes - small chin

Question 51

dietary recommendations for pregnant adolescents

Answer 51

calorie intake is increases more for asolescents that are pregnant