Nutrition in Pregnancy

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Included In This Lesson

Study Tools For Nutrition in Pregnancy

Prenatal Nutrition (Picmonic)
Pregnancy Nutritional Recommendations (Cheatsheet)
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Outline

Overview

  1. Expected weight gain is 25-35 lbs for women with a normal prepregnancy weight
  2. Education on healthy food options and good nutrition is essential

Nursing Points

General

  1. Promote healthy food and weight gain
  2. Mother is NOT eating for two
    1. Increase of approximately 300 calories/day
    2. Increase of 500 calories/day for lactation after delivery

Assessment

  1. Monitor for pica
    1. Eating non-food substances (clay, ice, starch)
    2. May have cultural influences
  2. Cultural Considerations
    1. Ensure you assess for cultural needs or influences before making dietary recommendations
      1. We can help to accommodate
    2. In religions that routinely fast, pregnant women are typically exempt but they may choose to limit or change intake during traditional fasting times
  3. Foods to avoid
    1. Seafood high in mercury (swordfish, shark, King mackerel, etc).  
    2. May have foods with small amounts of mercury, but limit servings to a few meals a week (shrimp, trout, catfish).  
    3. Limit tuna to less than 6oz/week due to inconsistent mercury levels
    4. All raw fish
    5. Undercooked meat, eggs, poultry
    6. Lunchmeat
      1. Could heat lunchmeat until steaming to avoid listeria
    7. Unpasteurized foods
      1. Some cheeses
    8. Excessive caffeine
      1. 1 cup a day
    9. Alcohol
      1. No safe amount, see FAS lesson
    10. Unwashed fruits and veggie
  4. Assess water intake
  5. Good amounts of calcium needed for the fetal bone and teeth development
  6. Prenatal vitamin
  7. Iron deficient anemia
    1. Common in pregnancy
    2. Spinach and legumes are high in iron

Therapeutic Management

  1. Some prenatal discomforts can be remedied with dietary changes
    1. Eliminate chocolate or caffeine for heartburn
    2. Increase carb intake for nausea
    3. Small frequent meals to help with nausea

Nursing Concepts

  1. Nutrition
  2. Human Development

Patient Education

  1. The importance of healthy diet
  2. Important facts
    1. Foods to avoid
    2. Prenatal vitamins
    3. Calcium
    4. Necessary calories
  3. Provide resources for further reading and reliable places to go with questions
    1. Educate vegetarian or vegan clients about the importance of consumption of complete proteins and vitamins (Vit D, calcium, zinc, B12, omega 3’s)

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Transcript

I will explain nutrition in pregnancy and the importance of healthy nutrition.

It is important in pregnancy that healthy nutrition is maintained not just for the mother and fetal development but even has been found to go further and affect the child’s health throughout life
So the expected weight gain is 25-35 lbs for women with a normal prepregnancy weight. Underweight women should gain 28-40 lbs and Overweight should gain 15-25 lbs.I wanted to point out that you might have a normal or underweight person that is less healthy then an obese person and vise versa. Just because someone is small doesn’t mean they have good nutrition so this can not be overlooked. Helping the patients understand healthy food options and good nutrition is essential.
So let’s look at some of the things we need to assess in our pregnant patients. We need to monitor a patient for pica. Pica is when a patient eats non food substances. Examples of this are clay, ice, starch. It usually means they are deficient in something such as iron and crave other items. Cultural influences should always be assessed. What cultural influences do they practice that deal with nutrition? Are there foods they avoid or certain things they eat on certain days? We can help accommodate if we know. Seafood can be high in mercury and should really be avoided. We want low mercury. Some meals with shrimp, trout, or catfish are lower in mercury and can be eaten a few times a week. Tuna is less consistent in mercury so this should be limited because of inconsistency. Raw fish should absolutely never be eaten. Undercooked meat, eggs, poultry should be avoided. If meat is cooked well done it is safe. Lunch meat should be avoided because of possible listeria bacteria. If the patient wants to heat the deli meat that is ok to eat.
Caffeine is ok in pregnancy but in moderation. Caffeine intake should be 200mg or less of caffeine a day. This is around 1-1.5 cups of coffee. Alcohol needs to be avoided. There’s really no known safe amount of alcohol in pregnancy. Fruit and vegetable intakes should be assessed. It is important that the diet includes fruits and veggies but we need to make sure they are washed well. Water intake is very important. We need to assess that the patient is getting enough water.
Cheeses that are not pasteurized are unsafe. They need to eat pasteurized cheese. Usually if it is a soft cheese that means it is non-pasteurized. This is feta and goat cheese as examples. Iron is something a lot of women need added to their diet because they become anemic. Foods high in iron are things like legumes and spinach. Good amounts of calcium are needed in pregnancy not just for regular health but also for fetal bone and teeth growth. Prenatal vitamins are also essential to continue to encourage. We need to make sure this is being taken specifically for the extra folic acid. The folic acid will help prevent neural tube defects.
Some prenatal discomforts can be remedied with dietary changes for instance eliminating chocolate or caffeine could help with heartburn discomfort and the women that suffer with nausea could increase carbohydrates and eat small frequent meals to help.

Nutrition and human development are the nursing concepts because we need to have good nutrition to have good human development in pregnancy.
Calcium is important to remember for fetal bone and teeth development. Remember that meats should not be undercooked and deli meat needs to be heated. Seafood that is low in mercury is ok in moderation and no raw fish. Cheeses need to be pasteurized. Weight gain is also important to remember. Overweight women should gain 15-25 lbs. Normal weight should gain 25-35 lbs and underweight women should gain 28-40 lbs. Caffeine is ok in moderation and remember chocolate and teas have caffeine in them

Make sure you check out the resources and videos that are attached to this lesson. Also review food items that are high in iron, folic acid, and foods to avoid as these are frequent test questions. Now, go out and be your best selves today. And, as always, happy nursing.

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Concepts Covered:

  • Test Taking Strategies
  • Respiratory Disorders
  • Prenatal Concepts
  • Prefixes
  • Suffixes
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Bipolar Disorders
  • Community Health Overview
  • Immunological Disorders
  • Childhood Growth and Development
  • Medication Administration
  • Adulthood Growth and Development
  • Learning Pharmacology
  • Anxiety Disorders
  • Basic
  • Factors Influencing Community Health
  • Integumentary Disorders
  • Trauma-Stress Disorders
  • Somatoform Disorders
  • Fundamentals of Emergency Nursing
  • Dosage Calculations
  • Depressive Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Eating Disorders
  • Substance Abuse Disorders
  • Psychological Emergencies
  • Hematologic Disorders
  • Pregnancy Risks
  • Concepts of Population Health
  • Emotions and Motivation
  • Delegation
  • Oncologic Disorders
  • Prioritization
  • Postpartum Complications
  • Endocrine and Metabolic Disorders
  • Basics of NCLEX
  • Fetal Development
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Labor Complications
  • Musculoskeletal Trauma
  • EENT Disorders
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Tissues and Glands
  • Developmental Theories
  • Postpartum Care
  • Cardiovascular Disorders
  • Renal Disorders
  • Newborn Care
  • Disorders of Pancreas
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Cardiac Disorders
  • Musculoskeletal Disorders
  • Female Reproductive Disorders
  • Shock
  • Infectious Disease Disorders
  • Nervous System
  • Hematologic Disorders
  • Disorders of the Posterior Pituitary Gland
  • Psychotic Disorders

Study Plan Lessons

12 Points to Answering Pharmacology Questions
Care of the Pediatric Patient
Menstrual Cycle
54 Common Medication Prefixes and Suffixes
Advance Directives
Family Planning & Contraception
Vitals (VS) and Assessment
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Epidemiology
Essential NCLEX Meds by Class
Growth & Development – Infants
6 Rights of Medication Administration
Growth & Development – Toddlers
Health Promotion & Disease Prevention
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Legal Considerations
HIPAA
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Anxiety
Basics of Calculations
Brief CPR (Cardiopulmonary Resuscitation) Overview
Cultural Care
Gestation & Nägele’s Rule: Estimating Due Dates
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Environmental Health
Fire and Electrical Safety
Generalized Anxiety Disorder
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Oral Medications
Pediculosis Capitis
Post-Traumatic Stress Disorder (PTSD)
Burn Injuries
Fundal Height Assessment for Nurses
Injectable Medications
Somatoform
Technology & Informatics
Fall and Injury Prevention
IV Infusions (Solutions)
Maternal Risk Factors
Complex Calculations (Dosage Calculations/Med Math)
Mood Disorders (Bipolar)
Depression
Isolation Precaution Types (PPE)
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Suicidal Behavior
Physiological Changes
Sickle Cell Anemia
Discomforts of Pregnancy
Antepartum Testing
Hemophilia
Nutrition in Pregnancy
Communicable Diseases
Disasters & Bioterrorism
Maslow’s Hierarchy of Needs in Nursing
Benzodiazepines
Delegation
Nephroblastoma
Prioritization
Chorioamnionitis
Triage
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Fever
Overview of the Nursing Process
Dehydration
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Therapeutic Communication
Defense Mechanisms
Leopold Maneuvers
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Intussusception
Abuse
Constipation and Encopresis (Incontinence)
Patient Positioning
Complications of Immobility
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Preterm Labor
Urinary Elimination
Bowel Elimination
Precipitous Labor
Dystocia
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Postpartum Physiological Maternal Changes
Bronchiolitis and Respiratory Syncytial Virus (RSV)
MAOIs
Postpartum Discomforts
Breastfeeding
Asthma
SSRIs
Cystic Fibrosis (CF)
TCAs
Congenital Heart Defects (CHD)
Intake and Output (I&O)
Defects of Increased Pulmonary Blood Flow
Blood Glucose Monitoring
Postpartum Hemorrhage (PPH)
Defects of Decreased Pulmonary Blood Flow
Mastitis
Insulin
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Histamine 1 Receptor Blockers
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Histamine 2 Receptor Blockers
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Renin Angiotensin Aldosterone System
Head to Toe Nursing Assessment (Physical Exam)
Head to Toe Nursing Assessment (Physical Exam)
Meconium Aspiration
Meningitis
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Spina Bifida – Neural Tube Defect (NTD)
ACE (angiotensin-converting enzyme) Inhibitors
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Scoliosis
Metronidazole (Flagyl) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Atypical Antipsychotics
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Epoetin Alfa
HMG-CoA Reductase Inhibitors (Statins)
Magnesium Sulfate
NSAIDs
Corticosteroids
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Vasopressin
Dissociative Disorders
Eczema
Proton Pump Inhibitors
Schizophrenia