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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My Study Plan (MED-SURG for NCLEX)

Concepts Covered:

  • Respiratory Disorders
  • EENT Disorders
  • Prenatal Concepts
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Integumentary Disorders
  • Oncology Disorders
  • Preoperative Nursing
  • Musculoskeletal Trauma
  • Disorders of the Posterior Pituitary Gland
  • Hematologic Disorders
  • Renal Disorders
  • Labor Complications
  • Immunological Disorders
  • Upper GI Disorders
  • Neurological Emergencies
  • Disorders of Pancreas
  • Musculoskeletal Disorders
  • Cardiac Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Integumentary Important Points
  • Pregnancy Risks
  • Noninfectious Respiratory Disorder
  • Urinary Disorders
  • Vascular Disorders
  • Eating Disorders
  • Lower GI Disorders
  • Intraoperative Nursing
  • Neurologic and Cognitive Disorders
  • Central Nervous System Disorders – Brain
  • Circulatory System
  • Postoperative Nursing
  • Liver & Gallbladder Disorders
  • Central Nervous System Disorders – Spinal Cord
  • Emergency Care of the Cardiac Patient
  • Peripheral Nervous System Disorders
  • Substance Abuse Disorders
  • Female Reproductive Disorders
  • Postpartum Complications
  • Fetal Development
  • Shock
  • Emergency Care of the Neurological Patient
  • Labor and Delivery
  • Postpartum Care
  • Newborn Care
  • Newborn Complications

Study Plan Lessons

ABGs Nursing Normal Lab Values
Glaucoma
Menstrual Cycle
X-Ray (Xray)
ABG (Arterial Blood Gas) Interpretation-The Basics
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
Burn Injuries
Cataracts
Computed Tomography (CT)
Family Planning & Contraception
Informed Consent
Nursing Care and Pathophysiology for Cushings Syndrome
Macular Degeneration
Magnetic Resonance Imaging (MRI)
Preoperative (Preop)Assessment
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology for Pancreatitis
Preoperative (Preop) Education
Cerebral Angiography
Hearing Loss
Hypotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Preoperative (Preop) Nursing Priorities
Respiratory Acidosis (interpretation and nursing interventions)
Thrombocytopenia
Blood Transfusions (Administration)
Cardiovascular Angiography
Fractures
Nursing Care and Pathophysiology for Hyperthyroidism
Hypertonic Solutions (IV solutions)
Integumentary (Skin) Important Points
Preload and Afterload
Respiratory Alkalosis
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Echocardiogram (Cardiac Echo)
Nursing Care and Pathophysiology for Hypothyroidism
Metabolic Acidosis (interpretation and nursing diagnosis)
Performing Cardiac (Heart) Monitoring
Metabolic Alkalosis
Ultrasound
Base Excess & Deficit
Biopsy
Gestation & Nägele’s Rule: Estimating Due Dates
Potassium-K (Hyperkalemia, Hypokalemia)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
General Anesthesia
Gravidity and Parity (G&Ps, GTPAL)
Leukemia
Levels of Consciousness (LOC)
Sodium-Na (Hypernatremia, Hyponatremia)
Diabetes Management
Dialysis & Other Renal Points
Local Anesthesia
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Routine Neuro Assessments
Adjunct Neuro Assessments
Chloride-Cl (Hyperchloremia, Hypochloremia)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Fundal Height Assessment for Nurses
Moderate Sedation
Oncology Important Points
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Malignant Hyperthermia
Maternal Risk Factors
Intracranial Pressure ICP
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Cerebral Perfusion Pressure CPP
Nursing Care and Pathophysiology for Crohn’s Disease
Normal Sinus Rhythm
Physiological Changes
Post-Anesthesia Recovery
Red Blood Cell (RBC) Lab Values
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cholecystitis
Discomforts of Pregnancy
Nursing Care and Pathophysiology for Heart Failure (CHF)
Hemoglobin (Hbg) Lab Values
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Postoperative (Postop) Complications
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Antepartum Testing
Hematocrit (Hct) Lab Values
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Sinus Tachycardia
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Discharge (DC) Teaching After Surgery
Nutrition in Pregnancy
Pacemakers
White Blood Cell (WBC) Lab Values
Atrial Fibrillation (A Fib)
Platelets (PLT) Lab Values
Coagulation Studies (PT, PTT, INR)
Miscellaneous Nerve Disorders
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Albumin Lab Values
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Cholesterol (Chol) Lab Values
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of Hypertension (HTN)
Ammonia (NH3) Lab Values
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Chorioamnionitis
Nursing Care and Pathophysiology for Menopause
Stroke Assessment (CVA)
Nursing Care and Pathophysiology for Cardiomyopathy
Gestational Diabetes (GDM)
Stroke Therapeutic Management (CVA)
Disseminated Intravascular Coagulation (DIC)
Stroke Nursing Care (CVA)
Ectopic Pregnancy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Blood Urea Nitrogen (BUN) Lab Values
Creatinine (Cr) Lab Values
Fetal Development
Nursing Care and Pathophysiology for Hypovolemic Shock
Seizure Causes (Epilepsy, Generalized)
Nursing Care and Pathophysiology for Cardiogenic Shock
Fetal Environment
Seizure Assessment
Nursing Care and Pathophysiology for Distributive Shock
Fetal Circulation
Seizure Therapeutic Management
Urinalysis (UA)
Nursing Care and Pathophysiology for Seizure
Glucose Lab Values
Process of Labor
Hemoglobin A1c (HbA1C)
Mechanisms of Labor
Leopold Maneuvers
Fetal Heart Monitoring (FHM)
Nursing Care and Pathophysiology for Meningitis
Prolapsed Umbilical Cord
Placenta Previa
Abruptio Placentae (Placental abruption)
Preterm Labor
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Postpartum Discomforts
Breastfeeding
Postpartum Hemorrhage (PPH)
Mastitis
Initial Care of the Newborn (APGAR)
Newborn Physical Exam
Body System Assessments
Newborn Reflexes
Babies by Term
Meconium Aspiration
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Newborn of HIV+ Mother
Hemodynamics
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)