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:

  • Cardiac Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of Pancreas
  • Neurological Emergencies
  • Noninfectious Respiratory Disorder
  • Pregnancy Risks
  • Postpartum Complications
  • Gastrointestinal Disorders
  • Musculoskeletal Trauma
  • Hematologic Disorders
  • Respiratory Disorders
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Basic
  • Factors Influencing Community Health
  • Fundamentals of Emergency Nursing
  • Integumentary Disorders
  • Emotions and Motivation
  • Delegation
  • Prioritization
  • Test Taking Strategies
  • Basics of NCLEX
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Tissues and Glands
  • Developmental Theories
  • Renal Disorders
  • Newborn Care
  • Upper GI Disorders
  • Substance Abuse Disorders
  • Prenatal Concepts
  • Fetal Development
  • Labor and Delivery
  • Labor Complications
  • Postpartum Care
  • Newborn Complications
  • Childhood Growth and Development
  • Adulthood Growth and Development
  • Hematologic Disorders
  • Oncologic Disorders
  • Endocrine and Metabolic Disorders
  • EENT Disorders
  • Cardiovascular Disorders
  • Renal and Urinary Disorders
  • Neurologic and Cognitive Disorders
  • Musculoskeletal Disorders
  • Infectious Disease Disorders
  • Eating Disorders
  • Oncology Disorders
  • Vascular Disorders
  • Intraoperative Nursing
  • Postoperative Nursing
  • Circulatory System
  • Emergency Care of the Cardiac Patient
  • Shock

Study Plan Lessons

Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Postpartum Hemorrhage (PPH)
Pediatric Gastrointestinal Dysfunction – Diarrhea
Fractures
Nursing Care and Pathophysiology for Anemia
Asthma
Advance Directives
Legal Considerations
HIPAA
Brief CPR (Cardiopulmonary Resuscitation) Overview
Fire and Electrical Safety
Fall and Injury Prevention
Isolation Precaution Types (PPE)
Maslow’s Hierarchy of Needs in Nursing
Delegation
Prioritization
Triage
Overview of the Nursing Process
Therapeutic Communication
Defense Mechanisms
Abuse
Patient Positioning
Complications of Immobility
Urinary Elimination
Bowel Elimination
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Intake and Output (I&O)
Blood Glucose Monitoring
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Head to Toe Nursing Assessment (Physical Exam)
Menstrual Cycle
Family Planning & Contraception
Gestation & Nägele’s Rule: Estimating Due Dates
Gravidity and Parity (G&Ps, GTPAL)
Fundal Height Assessment for Nurses
Maternal Risk Factors
Physiological Changes
Discomforts of Pregnancy
Antepartum Testing
Nutrition in Pregnancy
Chorioamnionitis
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Mechanisms of Labor
Leopold Maneuvers
Fetal Heart Monitoring (FHM)
Prolapsed Umbilical Cord
Placenta Previa
Abruptio Placentae (Placental abruption)
Preterm Labor
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Postpartum Discomforts
Breastfeeding
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
Care of the Pediatric Patient
Vitals (VS) and Assessment
Growth & Development – Infants
Growth & Development – Toddlers
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Eczema
Impetigo
Pediculosis Capitis
Burn Injuries
Sickle Cell Anemia
Hemophilia
Nephroblastoma
Fever
Dehydration
Vomiting
Celiac Disease
Appendicitis
Intussusception
Constipation and Encopresis (Incontinence)
Conjunctivitis
Acute Otitis Media (AOM)
Tonsillitis
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Cystic Fibrosis (CF)
Congenital Heart Defects (CHD)
Defects of Increased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Nephrotic Syndrome
Enuresis
Cerebral Palsy (CP)
Meningitis
Spina Bifida – Neural Tube Defect (NTD)
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Scoliosis
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Base Excess & Deficit
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Red Blood Cell (RBC) Lab Values
Hemoglobin (Hbg) Lab Values
Hematocrit (Hct) Lab Values
White Blood Cell (WBC) Lab Values
Platelets (PLT) Lab Values
Coagulation Studies (PT, PTT, INR)
Albumin Lab Values
Cholesterol (Chol) Lab Values
Ammonia (NH3) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Creatinine (Cr) Lab Values
Urinalysis (UA)
Glucose Lab Values
Hemoglobin A1c (HbA1C)
X-Ray (Xray)
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
Cerebral Angiography
Cardiovascular Angiography
Echocardiogram (Cardiac Echo)
Ultrasound
Biopsy
Informed Consent
Preoperative (Preop)Assessment
Preoperative (Preop) Education
Preoperative (Preop) Nursing Priorities
General Anesthesia
Local Anesthesia
Moderate Sedation
Malignant Hyperthermia
Post-Anesthesia Recovery
Postoperative (Postop) Complications
Discharge (DC) Teaching After Surgery
Hemodynamics
Preload and Afterload
Performing Cardiac (Heart) Monitoring
Normal Sinus Rhythm
Sinus Bradycardia
Sinus Tachycardia
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Pacemakers
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock