Chapter 15, Maternal and Fetal Nutrition

Which micronutrients can be obtained through dietary sources to meet the nutritional needs of a pregnant client? Select all that apply.

Calcium Vitamin D Vitamin B12

Which meal is appropriate to recommend for a pregnant client who requires increased dietary folate?

Chicken and avocado sandwich

Which food is a common protein source for a Mexican client who is pregnant?

Chorizo (sausage

Which foods are appropriate to prevent calcium imbalance when replacing milk for a pregnant client? Select all that apply.

Cocoa Yogurt Buttermilk

Which foods are appropriate to suggest to prevent calcium deficiency for the client who maintains a vegan diet? Select all that apply.

Collards Dried figs Cooked dried bean

Which nursing instruction is appropriate when counseling a woman about getting enough iron in her diet?

Constipation is common with iron supplements

Which nursing instructions are appropriate for the pregnant client about relieving constipation? Select all that apply.

Consume at least 28 g of fiber per day." "Eat whole grains and fresh fruits." "Drink at least 50 mL/kg/day of fluids.

Dehydration may increase which risk in the client in the ninth month of pregnancy? Select all that apply

Cramping Contractions Preterm labor

Which nursing intervention is appropriate for the postpartum client's neonate who has neural tube defects (NTDs)?

Daily folic acid supplement of 0.4 mg

Which nursing information is appropriate to include when preparing to teach a client about calcium intake and pregnancy?

Dietary intake of calcium is generally inadequate.

Which examples of protein-containing foods are appropriate when developing a dietary teaching plan for a client on a vegetarian diet? Select all that apply.

Dried beans Seeds Peanut butter Peas

Which nursing instructions are appropriate for the pregnant client about relieving constipation? Select all that apply.

Drink more water

Which nursing instruction is appropriate for the pregnant client experiencing nausea and vomiting?

Eat small, frequent meals (every 2 to 3 hours)

Which nursing assessment finding is anticipated for a pregnant client with a history of poor nutritional intake?

Hyperactive bowel sounds

Which condition describes the pregnant client with severe and persistent vomiting who has lost weight, is dehydrated, and has electrolyte abnormalities?

Hyperemesis gravidarum

Which conditions is the postpartum client at risk for with a pre-pregnancy weight of 60 kg (132.2 lb) and a post-pregnancy weight of 80 kg (176.3 lb)? Select all that apply.

Hypertension Arteriosclerosis Diabetes mellitus

Which statement by the client indicates an understanding of the education regarding the concern of fetal exposure to high levels of mercury through maternal consumption of fish and seafood?

I will limit my intake of canned light tuna to 12 ounces per week."

Which condition is related to inadequate weight gain during pregnancy?

Intrauterine growth restriction

Which risk is the fetus exposed to after the first trimester when the pregnant client's weight gain is approximately 0.3 kg per week?

Intrauterine growth restriction (IUGR)

Which supplements are recommended for the pregnant client with severe anemia? Select all that apply.

Iron Zinc Copper

Which minerals and vitamins are recommended to supplement the pregnant client's diet?

Iron and folate

Which foods are recommended to increase the calcium intake of a pregnant client who is lactose intolerant? Select all that apply.

Kale Dried Beans

Which dietary finding is the rationale for the nursing instruction to the pregnant client to eat nuts, legumes, cocoa, and whole grains during the second trimester?

Magnesium

Which nursing information is appropriate regarding protein in the diet of pregnant clients?

Many protein-rich foods are also good sources of calcium, iron, and B vitamins.

Which factors contribute to the increased nutritional need during pregnancy? Select all that apply. One, some, or all responses may be correct.

Maternal mammary development Increased maternal blood volume Increased metabolic rate Development and growth of the uterine-placental-fetal unit

Which food item is appropriate to include in the vitamin B6-deficient pregnant client's diet to encourage normal fetal development?

Meat

Which dietary food source is recommended for a client to meet the metabolic changes associated with pregnancy?

Milk products

Which fetal impairment is the nurse trying to prevent by recommending the pregnant client avoid fish such as swordfish, tilefish, and king mackerel?

Neurologic development

Which body mass index (BMI) category is appropriate for the pregnant client whose pre-pregnant BMI was 23.5?

Normal

Which condition of the pregnant client warrants a recommendation from the primary health care provider to avoid adding salt to food at the table?

Received abnormal renal function test results

Which determination about calcium intake is appropriate for the pregnant client who is lactose intolerant, avoids dairy foods, and eats four pieces of French toast and three cups of cooked dried beans daily?

Requires additional calcium

Which is the priority nursing action when planning a diet for a pregnant client?

Review the client's current dietary intake.

Which nursing action is appropriate when evaluating the weight gain of a client in the second trimester of pregnancy whose body mass index (BMI) is 27, and the weight gain over the past four weeks is 2.4 lb?

Schedule the client for a routine appointment

Which dietary intake is appropriate for the pregnant client who is still playing tennis at 32 weeks of gestation?

Several glasses of fluid

Which diet instruction about fish to avoid is appropriate for the pregnant client to prevent the risk of fetal neurotoxicity? Select all that apply.

Shark Tilefish Swordfish

Which mineral intake is restricted in a pregnant client with renal failure?

Sodium

hich newborn conditions can result from taking vitamin A supplements in higher doses than prescribed? Select all that apply.

Spina bifida Cleft palate

Which statement describes the recommended weight gain and nutritional goals for the adolescent client who is pregnant?

The nutritional intake for adolescents is the same as for adults

Which suggestions about weight gain are accurate recommendations? Select all that apply.

Underweight women should gain 12.5 to 18 kg. Obese women should gain at least 7 kg. Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale The desirable weight gain during pregnancy varies among women.

Which deficiency can result in an inflamed red tongue and megaloblastic anemia for the pregnant client? 1

Vitamin B12

Which diet is recommended for the client who is 6 months pregnant and diagnosed with diverticulosis?

Whole grains, bran, vegetables, and fruits

Which food does the nurse instruct the Puerto Rican pregnant adult client to consume on a daily basis to prevent calcium imbalance?

collards

Which nursing instruction is appropriate for the client who takes natural vitamin A supplements and multivitamin supplements prescribed by the health care provider and eats a lot of carrots and green salads?

"Avoid taking natural vitamin A supplements." Excess intake of vitamin A has been associated with spina bifida and cleft palate in the fetus. Therefore the nurse would ask the client to avoid taking natural vitamin A supplements. Green leafy vegetables are good sources of nutrients such as calcium, iron, and fiber. Thus the nurse would not ask the client to restrict the intake of green leafy vegetables. The client would not stop taking recommended multivitamin supplements because they are required for proper growth and development of the fetus. Vitamin A is a fat-soluble vitamin; thus it is not excreted in water. Therefore the nurse need not ask the client to drink a lot of water along with the supplements.

Which is the priority nursing question to ask when evaluating a pregnant client's pattern of weight gain based on the data in the electronic health record (EHR)?

"Can you share with me what you routinely eat daily?"

Which statement by the client indicates effective learning regarding the prevention of nutritional deficiency associated with consumption of a vegetarian diet?

"I can mix some fortified soy milk into my cereal."

Which nursing suggestion is appropriate to prevent defects in future pregnancies for the client who recently had an abortion after learning that the fetus had a neural tube defect?

"Take 4 mg of folic acid every day."

Which is the expected total weight gain for the client with a singleton pregnancy during the first trimester?

1 to 2 kg

Which nursing response is appropriate to tell a pregnant client with a body mass index (BMI) of 22 what her pattern of weight gain should be during pregnancy?

2 to 5 pounds during the first trimester, and then 1 pound per week until the end of pregnancy A BMI of 22 represents a normal weight. Therefore a total weight gain for pregnancy is about 25 to 35 lb or about 2 to 5 lb in the first trimester and about 1 lb per week during the second and third trimesters. One pound per week throughout pregnancy is not the correct guideline. One pound per week during the first two trimesters and two pounds per week thereafter is not the correct guideline for weight gain during pregnancy. A total weight gain of 25 to 35 lbs is correct, but the pattern needs to be explained to the client. Topics

Which additional caloric intake information is appropriate to include in the teaching for a client who is 6 weeks postpartum and breastfeeding?

330 For the first 6 months during lactation, the client's nonpregnant caloric needs plus 330 calories are recommended. Nonpregnant caloric needs in addition to 340 calories are recommended during the second trimester. After 6 months of lactation, the client's nonpregnant caloric needs in addition to 400 calories are recommended. During the third trimester, the client's nonpregnant caloric needs in addition to 452 calories are recommended

Which dietary modifications are appropriate for the pregnant client who has a folate intake of approximately 580 mcg/day? Select all that apply

Add one extra slice of bread daily. Include one boiled egg every day. Include one-half cup of corn daily.

Which condition is expected after a laboratory report for a pregnant client shows low levels of serum ferritin?

Anemia

Which nursing interventions are appropriate to relieve symptoms of nausea for the pregnant client in her first trimester of pregnancy? Select all that apply.

Assessing if the client is well hydrated Assessing the client's weight gain pattern during pregnancy Reviewing measures already taken for the prevention of morning sickness

Which finding requires client education based on the evaluation of the data in the client's electronic health record (EHR)? Incorrect 1

Body mass index