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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Ob and fundamental

Concepts Covered:

  • Integumentary Disorders
  • Tissues and Glands
  • Pregnancy Risks
  • Prenatal Concepts
  • Newborn Complications
  • Fetal Development
  • Postpartum Complications
  • Basic
  • Factors Influencing Community Health
  • Legal and Ethical Issues
  • Microbiology
  • Fundamentals of Emergency Nursing
  • Concepts of Population Health
  • Understanding Society
  • Integumentary Disorders
  • Respiratory Disorders
  • Developmental Theories
  • Developmental Considerations
  • Musculoskeletal Trauma
  • Emotions and Motivation
  • Health & Stress
  • Intraoperative Nursing
  • Musculoskeletal Disorders
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Shock
  • Communication
  • Concepts of Mental Health
  • Neurological Emergencies
  • Psychological Emergencies
  • Trauma-Stress Disorders
  • Prioritization
  • Studying
  • Basics of NCLEX
  • Test Taking Strategies
  • Delegation
  • Documentation and Communication
  • Dosage Calculations
  • Medication Administration
  • Concepts of Pharmacology
  • Community Health Overview
  • Preoperative Nursing
  • Labor Complications
  • Disorders of Pancreas
  • Eating Disorders
  • Noninfectious Respiratory Disorder
  • Renal Disorders
  • Hematologic Disorders
  • Respiratory System
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Oncologic Disorders

Study Plan Lessons

Hygiene
Nutrition in Pregnancy
Antepartum Testing
Discomforts of Pregnancy
Physiological Changes
Transient Tachypnea of Newborn
Fetal Environment
Fetal Development
Fertilization and Implantation
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Infections in Pregnancy
Incompetent Cervix
Gestational HTN (Hypertension)
Hyperemesis Gravidarum
Hydatidiform Mole (Molar pregnancy)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Ectopic Pregnancy
Disseminated Intravascular Coagulation (DIC)
Gestational Diabetes (GDM)
Chorioamnionitis
Cardiac (Heart) Disease in Pregnancy
Anemia in Pregnancy
Abortion in Nursing: Spontaneous, Induced, and Missed
Maternal Risk Factors
Fundal Height Assessment for Nurses
Signs of Pregnancy (Presumptive, Probable, Positive)
Gravidity and Parity (G&Ps, GTPAL)
Gestation & Nägele’s Rule: Estimating Due Dates
Family Planning & Contraception
Menstrual Cycle
Brief CPR (Cardiopulmonary Resuscitation) Overview
Fire and Electrical Safety
Radiation Safety for Nurses
Disposal of Medical Waste
Fall and Injury Prevention
High-Risk Behaviors
Restraints 101
Isolation Precaution Types (PPE)
Immunizations (Vaccinations)
Infection Stages
Overview of Developmental Theories
Kohlberg’s Theory of Moral Development
Piaget’s Theory of Cognitive Development
Erikson’s Theory of Psychosocial Development
Family Structure and Impact on Development
Body Image Changes Throughout Development
Cultural Awareness and Influences on Development
Developmental Considerations for the Hospitalized Individual
Patient Positioning
Complications of Immobility
Types of Exercise
Mechanical Aids
Urinary Elimination
Bowel Elimination
Pain and Nonpharmacological Comfort Measures
Shock
Nurse-Patient Relationship
Therapeutic Communication
Defense Mechanisms
Self Concept
Patients with Communication Difficulties
Grief and Loss
Stress and Crisis
Abuse
The Nurse Routine
Thinking Like a Nurse
Critical Thinking
Nursing Process – Evaluate
Nursing Process – Implement
Nursing Process – Plan
Nursing Process – Diagnose
Nursing Process – Assess
Overview of the Nursing Process
Triage
Prioritization
Delegation
Maslow’s Hierarchy of Needs in Nursing
Handoff Report
SBAR Communication
Documentation Pro Tips
Documentation Basics
Complex Calculations (Dosage Calculations/Med Math)
IV Infusions (Solutions)
Injectable Medications
Oral Medications
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Basics of Calculations
Pharmacokinetics
Pharmacodynamics
Airway Suctioning
Artificial Airways
Hierarchy of O2 Delivery
Patient Education
Admissions, Discharges, and Transfers
HIPAA
Legal Considerations
Levels of Prevention
Health Promotion Assessments
Health Promotion Model
Nursing Care Delivery Models
Advance Directives
What Guides Nurses Practice
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
ABGs Tic-Tac-Toe interpretation Method
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
ABG (Arterial Blood Gas) Oxygenation
Lactic Acid
Base Excess & Deficit
Leukemia
Respiratory A&P Module Intro
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Lung Diseases Module Intro
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Respiratory Infections Module Intro
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Pneumonia
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Hierarchy of O2 Delivery
Artificial Airways
Vent Alarms
Blunt Chest Trauma
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Bronchoscopy
Thoracentesis