CHAPTER 8 OB

Which guidance related to a healthy diet during pregnancy will the nurse provide to a patient in her 1st trimester?

"Every day you need to have at least 6 ounces of protein from sources such as meat, fish, eggs, beans, nuts, soybean products, and tofu."

A patient at 8 weeks' gestation complains to the nurse, "I feel sick almost every morning. And I throw up at least two or three times a week." What is the nurse's best guidance for this patient?

"Try eating peanut butter on whole wheat bread right before going to bed."

A pregnant patient with significant iron-deficiency anemia is prescribed iron supplements. The patient explains to the nurse that she cannot take iron because it makes her nauseous. What is the best response by the nurse?

"Try taking the iron at bedtime on an empty stomach."

When explaining the recommended weight gain to your patient, the nurse's teaching should include which statement?

"Weight gain in pregnancy is based on the patient's prepregnant body mass index."

The nurse is teaching a pregnant patient about food safety during pregnancy and lactation. Which statements by the patient indicate she understood the teaching? (Select all that apply.)

- "I will limit my intake of shrimp to 12 oz a week." - "I will avoid the soft cheeses made with unpasteurized milk." - "I will not eat any swordfish or shark while I am pregnant or nursing."

The nurse is advising a lactose-intolerant pregnant patient about calcium intake. Which calcium sources are approximately equivalent to 1 cup of milk? (Select all that apply.)

- 3/4 cup of yogurt - 1 1/4 oz of hard cheese - 1 1/4 cups of ice cream

The nurse is teaching a patient taking prenatal vitamins how to avoid constipation. Which should the nurse plan to include in the teaching session? (Select all that apply.)

- Recommend a diet high in fruits and vegetables. - Encourage an increase in fluid consumption during the day. - Increase the intake of whole grains and whole grain products.

The nurse is teaching a breastfeeding patient about substances to avoid while she is breastfeeding. Which substances should the nurse include in the teaching session? (Select all that apply.)

- caffeine - alcohol - Appetite suppressants

A pregnant woman of normal weight enters her 13th week of pregnancy. If the patient eats and exercises as directed, what will the nurse anticipate as the ongoing weight gain for the remaining trimesters?

1 lb every week

Which patient is most at risk for a low-birth-weight infant?

18-year-old, 64 inches tall, body mass index is <18.5

A patient with a BMI of 32 has a positive pregnancy test. What is the maximum number of pounds that the nurse will advise the patient gain during the pregnancy?

20 lb

A patient in her fifth month of pregnancy asks the nurse, "How many more calories should I be eating daily?" What is the correct response by the nurse?

340 more calories a day

Which patient would require additional calories and nutrients?

A 20-year-old female who had a vaginal birth 5 months ago and is breastfeeding

A pregnant patient has lactose intolerance. Which recommendation will the nurse provide to best help the patient meet dietary needs for calcium?

Add foods such as nuts, dried fruit, and broccoli to the diet.

The nurse is meeting with a patient with an elevated BMI regarding an optimal diet for pregnancy. Which major source of nutrients should be a significant component of this patient's diet?

Complex Carbohydrates

In teaching a pregnant adolescent about nutrition, what should the nurse include in the care plan?

Determine the weight gain needed to meet adolescent growth and add 35 lb.

Changes in the diet of the pregnant patient who has phenylketonuria would include

Eliminating drinks containing aspartame

The nurse is conducting a prenatal nutrition education class for a group of nursing students. Which statement best describes the condition known as pica?

Ingestion of nonfood substances

Which patient has correctly increased her caloric intake from her recommended pregnancy intake to the amount necessary to sustain breastfeeding in the first 6 postpartum months?

From 2200 to 2530 calories per day

For the pregnant patient who is a vegan, what combination of foods will the nurse advise to meet the nutritional needs for all essential amino acids?

Grains and legumes

A pregnant patient's diet may not meet her need for folate. Which food choice is an excellent source of this nutrient?

Green leafy vegetables

A pregnant patient asks the nurse if she can double her prenatal vitamin dose because she does not like to eat vegetables. What is the nurse's response regarding the danger of taking excessive vitamins?

Has toxic effects on the fetus

Which is the most important reason for evaluating the pattern of weight gain in pregnancy?

Identifies potential nutritional problems or complications of pregnancy

To determine cultural influences on a patient's diet, what is the nurse's primary action?

Identify the food preferences and methods of food preparation common to the patient's culture.

When should iron supplementation during a normal pregnancy begin?

In the second trimester

A pregnant patient would like to know which foods, other than dairy products, contain the most calcium. Which food group would the nurse recommend?

Legumes

Which clinical finding is associated with inadequate maternal weight gain during pregnancy?

Low-birth-weight infant

In order to increase the absorption of iron by a pregnant patient, which beverage should an iron preparation be given with?

Orange juice

A patient postdelivery is concerned about getting back to her prepregnancy weight as soon as possible. She had only gained 15 lb during her pregnancy. Which assessment factor would be of concern at her 6-week postpartum checkup?

Patient has lost 30 lb during the 6-week period prior to her scheduled checkup.

When planning a healthy diet with a pregnant patient, what should the nurse's first action be?

Review the patient's current dietary intake.

The nurse is reviewing a list of foods high in folic acid with a patient who is considering becoming pregnant. The nurse determines that the patient understands the teaching when the patient states she will include which list of foods in her diet?

Spinach, orange juice, and fortified bran flakes

The traditional diet of Asian women includes little meat and few dairy products and may be low in calcium and iron. The nurse can assist a patient increase her intake of these foods by which action?

Suggest that she eat more tofu, bok choy, and broccoli.

A pregnant patient arrives for her first prenatal visit at the clinic. She informs the nurse that she has been taking an additional 400 mcg of folic acid prior to becoming pregnant. Based on the patient's history, she has reached 8 weeks' gestation. Which recommendation would the nurse provide regarding folic acid supplementation?

Tell the patient that she no longer has to take additional folic acid because it will be included in her prenatal vitamins

Which effect is a common response to both smoking and cocaine use in the pregnant patient?

Vasoconstriction