Chapter 8 Nutrition for Child Bearing
The recommended increase in caloric intake for the second and third trimesters.
340 calories in second
452 calories in third
is an invasive procedure performed in the first trimester to obtain chromosomal, metabolic, and genetic disorder information
Chorionic villus sampling
The goals of management of an ectopic pregnancy are
to prevent severe hemorrhage and preserve the fallopian tube so that future fertility is retained.
Used to prevent preeclampsia from progressing to generalized eclamptic seizures, may have adverse effects. Adverse effects such as respiratory depression or absent deep tendon reflexes
Magnesium Sulfate
___________ use is a widespread problem that can have devastating fetal and neonatal effects, which may persist and become long-term developmental problems for the child.
Polysubstance
The recommended weight gain during pregnancy for a normal pre-pregnancy weight is
25-35 lbs
(1.1-4.4 lbs in 1st trimester and then
0.8-1lb per week after)
is a method of measuring blood flow pa\erns in fetal circulation. Flow that is normal is associated with adequate fetal oxygenation. Absent or reversed flow is abnormal and is associated with a poor fetal prognosis.
Fetal Doppler flow ultrasound
These two Disorders of the placenta are responsible for hemorrhagic conditions of the last half of pregnancy. Either condition may result in hemorrhage and death of the pregnant client or fetus
placenta previa
placental abruption
In addition to having an increased risk for congenital anomalies, the infant of a client with ____________ has an increased risk for hypoglycemia, hypocalcemia, hyperbilirubinemia, and respiratory distress syndrome, IUGR, or fetal macrosomia.
Preexisting diabetes
The birth of an infant with ___________produces strong emotions of shock and grief in the family. It calls for a sensitive response from the health care team to help the family grieve for the loss of the perfect or “fantasy” infant and form an attachment to the newborn.
Congenital anomalies
Abnormal prepregnancy weight, anemia, eating disorders, pica, multiparity, substance abuse, closely spaced pregnancies, and multifetal pregnancies are all
nutritional risk factors that warrant adaptations of diet during pregnancy and lactation.
reflect normal autonomic regulaAon and an intact central nervous system
Fetal heart rate accelerations
The most common cause of a spontaneous abortion (miscarriage) is chromosomal abnormalities. Treatment is aimed at preventing complications such as
hypovolemic shock
infection
providing emotional support for the grieving client and family
_______deficiency is associated with increased risk for spontaneous abortion, placental abruption, and fetal anomalies such as neural tube defects. ______ supplementation of 400 mcg (0.4 mg) daily is recommended for all clients of childbearing age to reduce the risk for neural tube defects.
Folic acid
Pregnancy loss at any stage produces grief, which should be acknowledged and expressed before it can be resolved. The nurse should allow for
unlimited contact between the family and the stillborn and gather memento packet for the family.
Lactating clients need an additional daily intake of ___ calories during the first 6 months, with the remaining ___ calories drawn from maternal stores for a total of ___ calories per day. During the second 6 months of breastfeeding, an added daily intake of ___ calories is needed.
Lactating clients need an additional daily intake of 330 calories during the first 6 months, with the remaining 170 calories drawn from maternal stores for a total of 500 calories per day. During the second 6 months of breastfeeding, an added daily intake of 400 calories is needed.
Methods of ______ include fetal movement counting, nonstress test, contraction stress test, biophysical profile, modified biophysical profile, and fetal Doppler flow ultrasound.
Antepartum Fetal Testing (APFT)
The primary goal of this testing is to decrease risk for permanent neurologic injury or stillbirth in high-risk pregnancies.
Preeclampsia is caused by generalized vasoconstricBon and vasospasm, which decreases circulaBon to all organs of the body, including the placenta. Major organs affected include the liver, kidneys, heart, and brain. Treatment of preeclampsia includes
reduced activity, reduction of environmental stimuli, and administration of medications to prevent generalized seizures and, when necessary, administration of antihypertensive agents.
Laboratory values for ________ are similar to those for iron deficiency. However, administration of iron is risky because increased iron absorption and storage makes the client susceptible to iron overload.
Thalassemia
Nursing care for the client who is placing the infant for adoption is based on the knowledge that adoption is an
act of love, not abandonment.
Pregnant and lactating clients should drink approximately ___ to___ cups of fluids each day. They should eat ___ to ___ oz of whole grains, ___ to __ cups of vegetables, __ cups of fruits, __ cups of the dairy group, and __ to __ oz of protein foods daily.
Pregnant and lactating clients should drink approximately 8 to 10 cups of fluids each day. They should eat 6 to 8 oz of whole grains, 2.5 to 3 cups of vegetables, 2 cups of fruits, 3 cups of the dairy group, and 6 to 6.5 oz of protein foods daily.
1. First-trimester screenings are used to identify these.
2. Second-trimester screenings are used to identify these.
1. fetal chromosomal anomalies ex: trisomy 21
2. Performed between 15 and 22 weeks and show risk for trisomy 21, trisomy 18 and neural tube defect (NTDs)
Adverse effects of gestational diabetes for the pregnant client include
Increased urinary tract infections, polyhydramnios, premature rupture of membranes, and the development of preeclampsia.
__________ that occur during pregnancy can be transmitted to the fetus in two ways: across the placenta or by exposure to organisms during birth. Although they may be mild or even subclinical in the pregnant client, _________ can have serious effects on the fetus and neonate.
Viral infections
What are four types of surrogacies?
Traditional
gestational
altruistic
commercial