N303 - Ch 15 Ob

Front 1

What is the first trimester of pregnancy crucial for?

Back 1

Embryonic and fetal organ development

Front 2

What are neural tube defects?

Back 2

Failures in the closure of the neural tube

Front 3

Who shows higher incidence of neural tube defects?

Back 3

Infants of women with poor folic acid intake

Front 4

Why is neural tube closure important?

Back 4

Because it is required for normal formation of the spinal cord

Front 5

What factors affect the outcome of pregnancy?

Back 5

1. Health status
2. Self-care
3. Family
4. Socioeconomic status
5. Education
6. Nutrition
7. Biology (Genetics)
8. Environment

Front 6

What foods are the sources of folic acid/folate?

Back 6

1. Liver
2. Legumes (peas, beans, lentils)
3. Vegetables (asparagus, spinach, broccoli, leafy greens)
4. Fruits (papaya, avocado, orange)
5. Breakfast cereals
6. Wheat germ
7. Pasta
8. Rice
9. Bread
10. Egg
11. Corn

(in order of good to adequate sources)

Front 7

What is the recommended daily consumption of folic acid for women wanting to get pregnant?

Back 7

400 mcg

Front 8

What factors contribute to the increase nutrient needs of pregnant women?

Back 8

1. The uterine-placental-fetal unit

2. Maternal blood volume and constituents: During pregnancy the total blood volume increases by 50% in women in their first pregnancies and more than this in multifetal pregnancies.

3. Maternal mammary development

4. Metabolic needs: BMRs are about 20% higher in pregnant women, which includes the energy costs for tissue synthesis

Front 9

What is the primary role of protein intake?

Back 9

Provide amino acids for the synthesis of new tissues

Front 10

What is the estimated energy expenditure for the first trimester?

Back 10

Same as in the prepregnancy state (i.e. 2000 kcal/day)

Front 11

What is the RDA during the second trimester?

Back 11

340 kcal greater than the prepregnancy needs

(i.e. 2000 + 340 = 2340 kcal)

Front 12

What is the RDA during the third trimester?

Back 12

462 kcal greater than the prepregnancy needs

(i.e. 2000 + 462 = 2462 kcal)

Front 13

What is the optimal weight gain during pregnancy?

Back 13

Not known

Front 14

What can occur with severely underweight pregnant women?

Back 14

They are more likely to have preterm labor and give birth to LBW infants

Front 15

How is BMI calculated?

Back 15

Weight / (Height)^2

{weight divided by height squared}

Front 16

What is the RDA during the second trimester?

Back 16

340 kcal greater than the prepregnancy needs

(i.e. 2000 + 340 = 2340 kcal)

Front 17

What is the RDA during the third trimester?

Back 17

462 kcal greater than the prepregnancy needs

(i.e. 2000 + 462 = 2462 kcal)

Front 18

What is the optimal weight gain during pregnancy?

Back 18

Not known

Front 19

What can occur with severely underweight pregnant women?

Back 19

They are more likely to have perterm labor and give birth to LBW infants

Front 20

How is BMI calculated?

Back 20

Weight / (Height)^2

{weight divided by height squared}

Front 21

What is classified as underweight?

Back 21

BMI < 19.8

Front 22

What is classified as normal weight?

Back 22

BMI = 19.8 to 26

Front 23

What is classified as overweight?

Back 23

BMI = 26 to 29

Front 24

What is classified as obese?

Back 24

BMI > 29

Front 25

What is the recommended weight gain during pregnancy for the normal weight?

Back 25

25 to 35 pounds

Front 26

What is the recommended weight gain during pregnancy for the obese?

Back 26

15 to 25 pounds

Front 27

What is the recommended weight gain during pregnancy for the underweight and teenagers?

Back 27

28 to 40 pounds

Front 28

What is the recommended weight gain during pregnancy for the women carrying twins or multifetuses?

Back 28

Prepregnant Kcal needs + 300 Kcal/fetus/day

Front 29

What is the pattern of weight gain for singleton pregnancy during the first trimester?

Back 29

Should only gain up to 3.5 pounds total

Front 30

What is the pattern of weight gain for singleton pregnancy during the second and third trimester?

Back 30

1 pound per week

Front 31

What is the recommended daily intake of fluids?

Back 31

8 to 10 glasses (2.3 L)

Front 32

What are the indicators of nutritional risk in pregnancy?

Back 32

1. Adolescence
2. Frequent pregnancies (3 within two years)
3. Poor fetal outcome in a previous pregnancy
4. Poverty
5. Poor diet habits with resistance to change
6. Use of tobacco, alcohol, or drugs
7. Weight at conception under or over normal weight
8. Problems with weight gain - any weight loss, weight gain less than 1 kg/mo after first trimester, weight gain more than 3 kg/mo after the first trimester
9. Multifetal pregnancy
10. Low Hgb and/or Hct values

Front 33

What is the recommended daily amount of ferrous iron during pregnancy?

Back 33

30 mg, starting at twelve weeks of gestation

Front 34

If maternal anemia is present, what is the recommended daily dose of iron?

Back 34

60 to 120 mg

Front 35

What are the benefits of iron supplementation?

Back 35

Enhances maternal iron status, which lead to increases in Hgb, serum iron, mean red cell volume, saturation of iron transport protein transferrin, and serum ferritin

Front 36

What helps with iron absorption?

Back 36

Vitamin C

Front 37

What may be tolerated even in people with lactose intolerance?

Back 37

1. Yogurt
2. Sweet acidophilus milk
3. Buttermilk
4. Cheese
5. Chocolate milk
6. Cocoa

Front 38

What are some sources of calcium for women who do not drink milk?

Back 38

1. Fish (sardines, salmon)
2. Beans and legumes
3. Leafy greens
4. Fruits (figs, OJ with calcium)
5. Pesto sauce or cheese sauce

Front 39

What consideration is important to remember with pregnant women who are vegans?

Back 39

They are generally anemic and have a higher tendency to tear during vaginal births

Front 40

What is the recommended daily calcium intake if it appears low?

Back 40

600 mg

Front 41

What is the benefit of calcium supplements?

Back 41

It can relieve leg cramps caused by imbalances in the calcium-phosphorus ratio

Front 42

Why are bone meal supplements not recommended for pregnant women?

Back 42

These supplements generally contain lead, which can freely cross the placenta and cause lead poisoning to the fetus

Front 43

Who are at risk of insufficient vitamin and mineral intake?

Back 43

Adolescents and low-income women

Front 44

What are good sources of magnesium?

Back 44

1. Dairy products
2. Nuts
3. Whole grains
4. Green leafy vegetables

Front 45

What is the function of sodium during pregnancy?

Back 45

Maintaining body water balance

Front 46

What is common with pregnancy?

Back 46

Edema, which is a response to the fluid-retaining effects of elevated levels of estrogen

Front 47

What is the recommended daily sodium intake during pregnancy?

Back 47

1.5 g/day, with an upper limit of 2.3 g/day

Front 48

What is the benefit of potassium?

Back 48

Reduced risk of hypertension

Front 49

What is the recommended intake of potassium?

Back 49

8 to 10 servings of unprocessed fruits and vegetables daily, along with moderate amounts of low-fat meats and dairy products to reduce sodium intake while providing adequate amounts of potassium

Front 50

What is zinc?

Back 50

A constituent of numerous enzymes involved in major metabolic pathways

Front 51

What is zinc deficiency associated with?

Back 51

Malformations of the CNS in infants

Front 52

What are the fat-soluble vitamins?

Back 52

Vitamins A, D, E, K

Front 53

Where are fat-soluble vitamins stored?

Back 53

Body tissues

(so, in the event of prolonged overdoses, these vitamins can reach toxic levels)

Front 54

What is the function of vitamin E?

Back 54

Protection against oxidative stress

(and pregnancy is associated with increased oxidative stress)

Front 55

What does oxidative stress cause?

Back 55

Preeclampsia

Front 56

What is preeclampsia?

Back 56

1. Disease encountered after 20 weeks of gestation or early in puerperium

2. A vasospastic disease process characterized by increasing HTN, proteinuria, and hemoconcentration

Front 57

What are sources of vitamin E?

Back 57

1. Vegetable oils and nuts (good sources)

2. Whole grains and leafy green vegetables (moderate sources)

Front 58

What complication can arise with EXCESSIVE intake of vitamin A?

Back 58

Congenital malformations

Front 59

What is the function of vitamin D?

Back 59

Helps with absorption and metabolism of calcium

Front 60

What are water-soluble vitamins?

Back 60

Small vitamins that are readily excreted in the urine

Front 61

What is the recommended daily intake of folate/folic acid?

Back 61

600 mcg

(50% more than prepregnancy status)

Front 62

Why is the increased intake of folate/folic acid recommended during pregnancy?

Back 62

Because of the increase in RBC production, as well as the nutritional requirements of the rapidly growing cells in the fetus and placenta

Front 63

What is the function of vitamin C?

Back 63

Plays an important role in tissue formation and enhances the absorption of iron

Front 64

What is the recommended daily intake of vitamin C?

Back 64

50 mg

Front 65

What is pica?

Back 65

The practice of consuming nonfood substances (e.g. clay, soil, laundry starch) OR excessive amounts of foodstuffs low in nutritional value (e.g. ice chips or freezer frost, baking powder to soda, and cornstarch)

Front 66

What complications can arise with pica?

Back 66

1. Lower hemoglobin levels

2. Risk that the nonfood items will be contaminated with heavy metals or other toxic substances

Front 67

What are food cravings?

Back 67

The urge to have ice cream, pickles, pizza, or some specific food

Front 68

What is believed to cause pica and food cravings?

Back 68

An innate drive to consume nutrients missing from the diet

(no research has supported this hypothesis)

Front 69

What is the focus of the efforts to improve the nutritional health of pregnant adolescents?

Back 69

1. Nutrition knowledge
2. Meal planning
3. Food preparation and selection skills of young women
4. Promoting access to prenatal care
5. Developing the nutrition interventions and educational programs that are effective with adolescents
6. Striving to understand the factors that create barriers to change in the adolescent population

Front 70

What causes preeclampsia?

Back 70

The cause is unknown, but there has been speculation that poor intake of calcium, magnesium, vitamin B6, and protein might foster its development

Front 71

What nutritional concepts are especially important for women who choose to exercise during pregnancy?

Back 71

1. Liberal amounts of fluids should be consumed before, during, and after exercise, because dehydration can trigger premature labor

2. The calorie intake should be sufficient to meet increased needs of pregnancy and the demands of exercise

Front 72

What are the recommended daily nutritional requirements for pregnant and lactating women?

Back 72

1. Pregnancy: 300+ cal/day
2. Lactating: 200+ cal/day = 500 cal/day
3. Fluids: 8-10 glasses/day
4. Lactating 3000ml/day
5. Nutritional dense food:
*Whole grains 7 +
*Veggies 3-5 svg/day, all colors!
*Protein 60-80 gm/day
*Dairy 3+
*Fats 3 tsp

Front 73

What is the recommended intake of folic acid and iron for women after giving birth?

Back 73

Decreased since maternal blood volume decreases to nonpregnant levels

Front 74

What is the recommended intake of calcium for women after giving birth?

Back 74

600 mg

Front 75

What complications can arise from smoking during lactation?

Back 75

1. Impaired milk production
2. Risk of passive smoking by infant

Front 76

What complications can arise from alcohol use during lactation?

Back 76

1. Impairment of the infant's psychomotor development
2. Impairment of the milk-ejection reflex

Front 77

What complications can arise from caffeine use during lactation?

Back 77

Can lead to a reduced iron concentration in milk and consequently contribute to the development of anemia in the infant

Front 78

What does nutritional care and teaching involve?

Back 78

1. Acquainting the woman with the nutritional needs during pregnancy and the characteristics of an adequate diet, if necessary

2. Helping her to individualize her diet so that she achieves an adequate intake while conforming to her personal, cultural, financial, and health circumstances

3. Acquainting her with strategies for coping with the nutrition-related discomforts of pregnancy

4. Helping her use nutrition supplements appropriately

5. Consulting with and making referrals to other professionals

Front 79

What is WIC?

Back 79

A program that provides vouchers for selected foods to pregnant and lactating women, as well as infants and children at nutritional risk

Front 80

What is especially important for adolescents and women younger than 25 years to consume?

Back 80

Adequate amounts from the milk, yogurt, and cheese food group

Front 81

What is the recommended daily intake of dairy products for adolescents?

Back 81

At least 3 to 4 cups

Front 82

How many calories should lactating women consume daily?

Back 82

1800 kcal

Front 83

What vitamins and minerals should be added to a lactating woman's diet?

Back 83

Zinc, vitamin B6, folic acid, and calcium

Front 84

Why do lactating women need calcium?

Back 84

To allow for both milk formation and maintenance of maternal bone mass

Front 85

What is the food plan of women with diabetes?

Back 85

Usually includes four to six meals and snacks daily, with the daily carbohydrate intake distributed fairly evenly among the meals and snacks

Front 86

What may be effective in reducing the severity of nausea?

Back 86

1. Antiemetic medications
2. Vitamin B6
3. Ginger

Front 87

What suggestions are helpful with alleviating nausea and vomiting?

Back 87

1. Eat dry, starchy foods (dry toast, crackers)
2. Avoid consuming excessive amounts of fluids early in the morning
3. Eat small amounts of food frequently (q 2-3 hrs)
4. Avoid skipping meals
5. Avoid sudden movements
6. Decrease intake of fried or fatty foods
7. Breathe fresh air
8. Eat foods served at cool temperatures
9. Avoid brushing teeth immediately after eating
10. Try salty and tart foods
11. Try herbal teas

Front 88

What can help prevent constipation?

Back 88

Improved bowel function generally results from increasing the intake of fiber in the diet because fiber helps to retain water within the stool, creating a bulky stool that stimulates intestinal peristalsis

Front 89

What are some sources of fiber?

Back 89

Bran and whole grain products, popcorn, and raw or lightly steamed vegetables

Front 90

What are vegetarian diets?

Back 90

Vegetables, fruits, legumes, nuts, seeds, and grains

Front 91

What are semivegetarians?

Back 91

In addition to the vegetarian diet, include fish, poultry, eggs, and dairy products, but not beef or poultry