Medical Nutrition, Therapy Maternal-Fetal Medicine - Assignment Example

MEDICAL NUTRITION THERAPY MATERNAL-FETAL MEDICINE MODULE Please answer questions concisely, with focus on nutritional implications. QUESTION Discuss the recommended rate and amount of weight gain during the gestational period. It was approved by Institute of Medicine that recommended weight gain should be: For women with BMI 18.5-24.9, normal weight -11.3-15.9kg(25-35 pounds) For women with BMI lower than 18.5, underweight- 12.7-18 kg(28-40 pounds) For women with BMI 25-29.8, overweight 6.8-11.3 kg(15-25 pounds) For women with BMI higher than 30, obese- 5-9 kg (11-20 pounds) The rate of weight gain should be 2-4 pounds during first trimester and than 1 pound per week during two last trimesters. QUESTION 2. What special requirements does the pregnant woman have with respect to calories and protein to attain the identified weight gain? During pregnancy women require between 2.200-2.900 calories per day. During first trimester extra calories are not needed. During second trimester 350 additional calories per day are recommended. During third trimester extra 450 calories per day are required. It is important for pregnant woman to intake 70g of protein per day. QUESTION 3. What is an appropriate nutrition care plan for an obese woman who is pregnant? An underweight woman? QUESTION 4. Develop a nutrition care plan for the patient with hyperemesis. Why does hyperemesis occur? (Hyperemesis – prolonged, persistent vomiting associated with an increase in the maternal free thyroid hormone) QUESTION 5. What is toxemia? In the past toxemia was treated with which dietary restriction? Why is this no longer done? Toxemia is complication that occurs during pregnancy and it is characterized by acute hypertension, albuminuria (increased amount of protein albumin in the urine) and edema. QUESTION 6. Define the following A. AEDF- absent umbilical arterial and diastolic flow, is a feature that characterized fetal vascular stress, can be detected in mid and late pregnancy B. Amenorrhea – absence of menstruation C. Cerclage- is a procedure that help to avoid premature birth, cervix is closed using sutures D. Cystocele – bulging of the bladder into the vagina E. D&C –dilation and curettage , gynecological procedure that usually used for the first trimester abortion, include dilation of the cervix and surgical removal of the internal layer of the uterus F. Ectopic pregnancy – fetal growth in the fallopian tubes G. Endometriosis – displaced growth of the tissue that lines uterus H. Food safety in pregnancy-following of the nutrition care plan for pregnant women to avoid foodborne illness. I. Gravida – amount of times that a woman has been pregnant J. Hellp syndrome- damage of the liver and blood cells that occur during pregnancy K. Incompetent cervix- early dilation of the cervix L. IUGR – Intrauterine Growth Restriction, poor growth of a baby in mother`s uterus M. IVF –In vitro fertilization, fertilization of the egg by the sperm outside the body N. Multiparity – the production of more than one offspring during one pregnancy O. Myoma – benign tumor formed in the uterus P. Oopherectemy – surgical removal of ovaries Q. Parity – the state of having given birth to a child R. PCOS Polycystic Ovarian Syndrome-disorders of woman menstrual cycle, fertility, hormones, insulin production and appearance. S. Pica – craving to eat nonfood substances T. Placenta abruption – wall of the uterus is separated from the placenta U. Placenta Previa – abnormal located placenta that totally covers the cervix V. TAH Total Abdominal Hysterectomy – surgical removal of the uterus W. QUESTION 7. Discuss PCOS and fertility. A. During Polycystic Ovarian Syndrome ovaries are formed that contain follicles with hormones that cause different changes in the woman bode. The disorders in women hormonal production during Polycystic Ovarian Syndrome usually cause women infertility in 75% of cases. The main reason of infertility during PCOS is anovulation, that occurs when ovaries do not release an oocyte and ovulation cannot occur. B. QUESTION 8. Find the most suitable definition for the following medical abbreviations (with a maternity context): A. C/S B. CSII C. GDM D. IUP E. NSVD F. PEC G. TIUP H. QUESTION 9. What are the nutritional concerns in a multiparity pregnancy? A. QUESTION 10. What are the dietary reference intakes for folic acid, iron and calcium for pregnant women? How do these compare to the DRI’s for non-pregnant women? What are good sources of these nutrients? A. Pregnant woman have to intake 600-800 micrograms of folic acid per day despite non-pregnant women who daily requirement of folic acid is 400 micrograms per day. B. Foods that contain high amount of folic acid are cabbage, oranges, broccoli, spinach, lentils, asparagus, and sunflower seeds. C. QUESTION 11. What nutritional recommendations/ concerns would you have for a pregnant female who is a strict vegetarian? A. To maintain healthy pregnancy strict vegetarian woman need to follow well-balanced diet. It is necessary to receive an appropriate dose of folic acid, vitamin B12, E, D and calcium, B. QUESTION 12. What are the nutritional requirements for a breastfeeding woman? Name three (3) nutrients a breastfeeding mom should focus on. A. B. AND-Evidence Analysis Library C. On the homepage, click on the “Projects” tab and search for Vegetarian Nutrition. D. Click, scroll down and select first: VN: Life-cycle and vegetarian diets (2007-2009) and then VN: Macronutrients in pregnancy (2007). E. Under assessment, explain this question: Are birth outcomes different for mothers who maintain a vegetarian versus an omnivorous diet during pregnancy? F. State the evidence’s grade and its meaning. G. H. Click on the “Projects” tab and search for Gestational Diabetes. I. Click, scroll down and select GDM: Physical activity (2008) J. Explain this question: In women with GDM, what is the relationship between physical activity during pregnancy and maternal/neonatal outcomes and glycemic control? K. State the evidence’s grade and its meaning. L. M. Gail is a 26 year-old lady with type 1 diabetes who wants to become pregnant and is seeking your advice about how to have a healthy baby and keep her blood sugars under good control. What would you advise her? N. O. CASE STUDY P. Q. MC is a 35-year old female with past medical history of hypertension, being regulated with Labetalol. She is pregnant at 30 weeks of gestation and was diagnosed with gestational diabetes a week ago. The physician prescribed Glyburide 2.5mg in am daily and asked her to monitor her blood glucose 4x/day (fasting and 1-hour post-prandial). MC has no other medical conditions and continues taking the antihypertensive agent as per physician. MC’s pre-pregnancy weight is 205 Lbs. (93Kg) and has gained 25 Lbs. during pregnancy. Her height is 5’5”. R. S. MC’s blood glucose levels are: T. Glucose U. Fasting glucose V. 1 hr. post-prandial W. 1 hr. post-prandial X. 1 hr. post-prandial Y. Time Z. 0700 AA. 0900 AB. 1300 AC. 1900 AD. Result AE. 98 mg/dL AF. 150 mg/dL AG. 135 mg/dL AH. 145 mg/dL AI. NSUH within target range levels AJ. AK. < 90 mg/dL AL. AM. < 140 mg/dL AN. AO. < 140 mg/dL AP. AQ. < 140 mg/dL AR. 1. Assess M.C.’s calorie and protein needs. AS. 2. Create a meal plan for M.C., which includes consistent carbohydrate, for three meals and 3 snacks based on the calorie level assessed above. a. Include your total calorie level selected b. Include the breakdown of the meal plan for carbohydrate, protein and fat c. Indicate how much carbohydrate is provided at each meal. AT. 3. Discuss the mechanism of action of Glyburide. AU. 4. Discuss the drug-nutrient interaction. AV. 5. Identify a nutrition diagnosis and intervention(s). AW. 6. Write a nutrition assessment using S.O.A.P. format. AX. AY. References: AZ. http://www.womenshealth.gov BA. http://www.mckinley.illinois.edu/Handouts/pregnancy_lactation.html BB. http://www.marchofdimes.com BC. http://www.nih.gov BD. http://www.diabetes.org BE. Read More