Nutrition - Chapters 9 & 10

What factors define a high risk pregnancy?

-BMI <18.5 or >25 -eating disorders -poverty -smoking, alcohol -age (<15 or >35) -twins

A mother/baby-friendly worksite provides benefits to employers, including ___________________ and increased employee morale. (Check all those that apply). -higher employee absenteeism -a reduction in company health care costs -reduction in employee turnover -slight decrease in productivity expectations

-a reduction in company health care costs -reduction in employee turnover

Where does water come from (i.e., food, drink, metabolic water) and where does it leave the body?

-as preformed water in liquids that are consumed -as preformed water in foods that are eaten -as a product of cell oxidation when nutrients are burned in the body for energy -leaves body through kidneys, skin, lungs, and feces

Know the major functions of Na, K, and Cl.

-maintain osmotic equilibrium, nerve transmission, acid-base balance, absorption of amino acids -K--> carb metabolism -Cl--> hydrochloric acid

Complete protein sources that can help meet the increased nutrient needs during pregnancy are: A. Cow's milk and soy milk B. Baked beans and green beans C. Orange juice and grapefruit juice D. Whole-grain cereal and whole-grain bread

A. Cow's milk and soy milk

A patient with uncontrolled diabetes who is experiencing a high serum blood glucose level may present to the clinic with: A. Polyuria B. Anuria C. Oliguria D. Dysuria

A. Polyuria (passing abnormally large amounts of urine)

The hormone responsible for promoting conservation of sodium in the kidney is ________________. A. aldosterone B. antidiuretic hormone C. renin D. thyroxine E. angiotensinogen

A. aldosterone

A pregnancy is considered high risk if the mother ________________. A. is 16 years old B. works full time C. exercises four or five times per week D. is vegetarian

A. is 16 years old

The B-complex vitamins are required in greater amounts during pregnancy because ________________. A. metabolic activities increase B. more hemoglobin is synthesized C. fetal demands for the vitamins are high D. the vitamins are excreted in greater quantities

A. metabolic activities increase

The main electrolyte that surrounds the outside of the cell is: A. sodium B. calcium C. potassium

A. sodium

The major electrolyte found guarding the water outside of the cells is ________________. A. sodium B. iron C. magnesium D. potassium E. chloride

A. sodium

What risks are associated with smoking and alcohol use during pregnancy?

Alcohol use during pregnancy may produce fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorder (FASD) Smoking during pregnancy = greater risk for adverse outcomes including: prematurity, low birthweight, stillbirth or SIDS

In the adult, the average intake of fluid from all sources is approximately _____ mL/day. A. 2800 B. 2400 C. 2200 D. 2000

B. 2400

__________________ are the reference normative standards for infant feeding and nutrition. A. Breast milk substitute B. Breastfeeding and human milk C. Cow and goat milk D. Infant formula

B. Breastfeeding and human milk

Substances that work with electrolytes to help maintain body fluid balance include: A. Dietary fiber B. Plasma proteins C. Blood hemoglobin D. Vitamin C

B. Plasma proteins

Which of the following growth charts should be used to plot the growth of exclusively breastfed infants? A. CDC growth charts B. WHO growth charts C. AAP D. FDA growth charts

B. WHO growth charts

The kidneys "launder" the blood by _________________. A. osmosis B. filtration C. diffusion D. active transport

B. filtration

____________ needs are increased during pregnancy due to development of the placenta, growth of the fetus, growth of maternal tissues, increased maternal blood volume, and for amniotic fluid. A. Complex carbohydrates B. Protein C. Linoleic acid D. Iron E. Glucose

B. protein

How long is exclusive breastfeeding recommended? And how long is breastfeeding recommended in general (i.e., even after solids have been introduced)?

Breast feeding is recommended for at least 1 year with iron-fortified solid foods added to the exclusive diet of breast milk at about 6 months of age

It has been calculated that more than ______ infant lives per year may be saved in the United States if 90% of mothers exclusively breastfed for 6 months. A. 100 B. 600 C. 900 D. 300

C. 900

Elderly adults are at risk for dehydration because of: A. Inability to dilute urine B. Decreased serum glucose levels C. Decreased thirst sensation D. Poor intestinal fluid absorption

C. Decreased thirst sensation

It is important to counsel women of childbearing age to consume adequate amounts of folic acid to reduce the risk of: A. Developing type 2 diabetes mellitus B. Developing hyperemesis gravidarum C. Malformation of the neural tube during the gestational period D. Poor absorption of calcium and phosphorus during fetal bone growth

C. Malformation of the neural tube during the gestational period

__________________ are retained in the blood vessels and help guard blood volume by influencing the shift of water in and out of capillaries. A. Electrolytes B. Proenzymes C. Plasma proteins D. Trace elements

C. Plasma proteins

Which of the following would be the most appropriate recommendation for a pregnant woman with "morning sickness"? A. Lemonade with added sugar and peppermint sticks B. A glass of hot decaffeinated tea with each meal C. Whole-wheat toast with small amount of light butter and small piece of fruit D. A meal of hot soup and Gatorade

C. Whole-wheat toast with small amount of light butter and small piece of fruit

Gestational diabetes is more common in women who have: A. anemia B. hyperemesis C. obesity D. hypertension

C. obesity

A good source of dietary folate is found in _______________. A. cheese B. skim milk C. oranges D. olive oil

C. oranges

IUGR stands for intrauterine growth _________. A. receptor B. regulator C. restriction D. risk

C. restriction

What is the difference between colostrum and mature milk?

Colostrum is first: rich in antibodies Mature milk: within a few days of delivery

During lactation, extra calories needed from dietary intake is approximately __________ kcal/day. A. 1200 B. 1000 C. 750 D. 330

D. 330

Daily kilocalorie needs during the second trimester exceed normal requirements by approximately _____ kcal. A. 200 B. 100 C. 500 D. 340

D. 340

The easiest way to measure fluid loss during a day of hard work in a hot climate is to: A. Measure and compare fluid intake and urine output B. Measure blood pressure throughout the day C. Determine serum sodium levels before and after work D. Measure body weight at the beginning and at the end of the day

D. Measure body weight at the beginning and at the end of the day

Iron needs increase during pregnancy because of ________________. A. fetal bone formation B. fetal breakdown of hemoglobin C. increased maternal iron excretion D. increased maternal blood volume

D. increased maternal blood volume

A mineral that occurs in the highest concentration in the intracellular fluid is _________________. A. magnesium B. phosphorus C. sodium D. potassium

D. potassium

An appropriate amount of weight gain during the first trimester of pregnancy for a normal-weight woman (prepregnancy) is _____________. A. ½ to 1 lb B. 6 to 10 lbs C. ½ lb D. 1 to 2 lb E. 2 to 4 lb

E. 2 to 4 lb

Thirst tends to be an unreliable index of fluid needs particularly in ___________________. A. pregnant women B. infants C. teenagers D. breastfeeding women E. older adults

E. older adults

What particles in blood maintain water balance? How? What are the physiologic buffer systems used to maintain pH balance in the body?

Electrolytes and plasma proteins. By osmotic pressure. Chemical buffer system (bicarbonate), respiratory and renal systems.

Women who are obese (BMI >30 kg/m2) need to gain more weight during pregnancy than women who have a pre-pregnancy weight in the normal BMI category. True or False?

False

You have to get your fluid intake from plain water. Other types of drinks do not count toward hydration needs. True or False?

False

The mother's blood volume typically increases by 10-25% during pregnancy. True or False?

False. The mother's plasma volume increases by 40-50% during pregnancy

Is high body water associated with high or low lean body mass? Why?

High

What benefits do baby and mom receive by breastfeeding?

Improved cognitive development in infants Antibodies improve infant's immune system --> reduced risk of disease and infection Mother has decreased bleeding, earlier return to pre-pregnancy weight, decreased risk of breast cancer...

What regulates osmotic pressure between cells and how? (i.e., Regulates water partitioning between extracellular fluid volume and intracellular fluid volume and how?)

The concentration of the various solute particles

Normal body water content ranges from 45%-75% of total body weight in adults. True or False?

True

Know the various compartments of body fluid. And what factors influence body water requirements?

Two main fluid compartments. ICF=60% ECF=40% Environment, activity level, functional losses, metabolic needs, age, and other dietary influences affect body water requirements

What percent of total body weight is water in an average woman? Man? How much fluid should a man and woman consume on a daily basis according to the DRIs?

Women are about 50% total body weight. Men are 60%. Women should consume 2.7 L (91 oz) a day. They should aim for 9.25 cups of water. Men should consume 3.7 L (125 oz) a day. They should aim for about 12.6 cups of water (or fluid).

What factors are associated with intrauterine growth restriction?

Women with high risk pregnancies have an elevated risk of IUGR. A fetus with IUGR is at risk for preterm birth and being small for gestational age. Low pre pregnancy weight, inadequate weight gain, inadequate folate and iron status, smoking, and alcohol are risk factors. Infants who suffer from IUGR are at higher risk for developing chronic disease as adults.

The ___________________ hormone is a first-line defense against hypovalemia. When activated, it acts on the kidneys to conserve water.

antidiuretic

The thin, yellow fluid first secreted by mammary glands for a few days after childbirth is called _________________.

colostrum

What signs and symptoms will be seen in pregnant women who have gestational diabetes? Pregnancy induced hypertension? Hyperemesis gravidarum? Eclampsia?

hyperemesis gravidarum: severe and unrelenting vomiting. loss of more than 5% of body weight gestational diabetes: unusual thirst, frequent urination, fatigue... abnormal carbohydrate metabolism, family history hypertension: "no symptoms"... severe headaches, blurred vision... increased blood pressure, protein in the urine eclampsia: seizures... abdominal pain, severe headaches

What hormones are involved with the process of breastfeeding (production of milk and milk let-down)?

nipple sucking stimulates prolactin: produces milk oxytocin: responsible for let-down reflex

___________________ is the passage of water through a membrane that separates solutions of different concentrations and that tends to equalize the concentration pressures of the solution on either side of the membrane.

osmosis

What are the weight gain recommendations, according to BMI, during pregnancy?

prepregnancy weight. weight gain underweight (BMI < 18.5) 28-40 lbs (12.5-18 kg) normal (BMI 18.5 - 24.9) 25-35 lbs (11.5-16 kg) overweight (BMI 25-29.9) 15-25 lbs (7-11.5 kg) obese (BMI >30) 11-20 lbs (5-9 kg)

How much do protein and caloric requirements/needs change during pregnancy and lactation?

second trimester - +340 kcal/day third trimester - +452 kcal/day (this is an increase of 15 to 20 %) lactating - +330 kcal/day DRI for protein of pregnant/lactating women is about 71 g/day (this is an increase of 25 g/day)

What is a teratogen? Know some nutrition-related examples.

something that causes a birth defect any drugs, viruses, infections, or other exposures that can cause embryonic/fetal developmental abnormality ex) alcohol