chp 8 nutrition obThe nursing instructor is teaching a group of students about preconception counseling and care. The student nurse asks the nurse about interventions that can decrease the incidence of spina bifida in the fetus. Which answer does the nurs

The nurse is caring for a patient with a singleton pregnancy. What is the expected total weight gain for the patient during the first trimester? 1 2 to 3 kg 2 1 to 2 kg 3 1.5 to 2 kg 4 0.5 to 1 kg

2 1 to 2 kg (3.5 ibs) During the first and second trimesters, growth takes place primarily in maternal tissues. During the third trimester, growth occurs primarily in fetal tissues. During the first trimester of a singleton pregnancy, the average total weight gain is only 1 to 2 kg. Greater-than-expected weight gain during pregnancy, such as 2 to 3 kg, can occur for various reasons, including multiple gestation, edema, gestational hypertension, and overeating. Weight gain of 1.5 to 2 kg or 0.5 to 1 kg may occur due to improper diet, which may lead to growth problems in the fetus.

A pregnant patient has severe and persistent vomiting. The patient has lost weight, is dehydrated, and has electrolyte abnormalities. Which condition does the nurse suspect that the patient has? 1 Tetany 2 Glossitis 3 Hypocalcemia 4 Hyperemesis gravidarum

4 Hyperemesis gravidarum is a condition associated with severe and persistent vomiting causing weight loss, dehydration, and electrolyte abnormalities. Tetany is a condition caused by vitamin D deficiency and is characterized by muscle cramps, spasms, or tremors. Glossitis is characterized by an inflamed red tongue; it does not lead to severe and persistent vomiting but may lead to weight loss. Hypocalcemia may lead to retardation of bone development in the infant.

The nurse finds that a 6-month-old breastfed infant is hyperactive and stays awake most of the time. What reason does the nurse suspect is behind this behavior? 1 The mother is on antibiotic therapy. 2 The mother is on anticoagulant therapy. 3 The mother drinks large amounts of alcohol. 4 The mother drinks large amounts of coffee.

4 Caffeine intake can lead to a reduced iron concentration in milk, resulting in anemia. Breastfed infants of mothers who drink large amounts of coffee or caffeine-containing soft drinks can be unusually active and wakeful. If the mother is on a limited dose of antibiotic therapy, it will likely not affect the breastfed infant. However, higher doses cause developmental abnormalities. If the mother is on anticoagulant therapy, it generally does not affect the infant. It is speculated that the mother's use of alcohol may affect the infant's psychomotor development and impair the milk-ejection reflex.

The nurse is developing a dietary teaching plan for a patient on a vegetarian diet. The nurse should provide the patient with which examples of protein-containing foods? Select all that apply. 1 Dried beans 2 Seeds 3 Peanut butter 4 Bagel 5 Peas

1,2,3,5 Dried beans, seeds, peanut butter, and peas provide protein. A bagel is an example of a whole grain food, not protein.

For the health of the mother and the fetus, what is the recommended period of time between pregnancies? 1 6 to 12 months 2 9 to 18 months 3 18 to 23 months 4 10 to 21 months

3 Pregnancies spaced at least 18 to 23 months apart are considered healthy for the mother and the fetus. The recommended period of time between pregnancies is not 6 to 12, 9 to 18, or 10 to 21 months.

Maternal anorexia nervosa and bulimia are associated with which complications of pregnancy? Select all that apply. 1 Miscarriage 2 Preeclampsia 3 Low birth weight 4 Gestational diabetes 5 Congenital anomalies 6 Postpartum depression

1,3,5,6 Eating disorders in pregnant women are associated with miscarriage, low birth weight, congenital anomalies, and postpartum depression. They are not associated with preeclampsia or gestational diabetes.

A pregnant woman has been prescribed folic acid by the primary health care provider. What explanation should the nurse give to the patient about the importance of taking folic acid during pregnancy? 1 "Folic acid can prevent neural tube defects in the fetus." 2 "Folic acid helps in the formation of bones in the fetus." 3 "Folic acid prevents the onset of Rett syndrome in fetus." 4 "Folic acid helps in the formation of coagulation factors."

1 Folic acid is required for the formation of the neural tube in the fetus. Therefore, folic acid is prescribed to the patient during pregnancy to prevent neural tube defects. Calcium is required for the formation of bones in the fetus. Rett syndrome results from a protein mutation in a gene and has no relation to folic acid. Coagulation factors are formed by vitamin K after childbirth. Folic acid will not help in the formation of bone, prevention of Rett syndrome, or the formation of coagulating factors in the newborn.

With regard to protein in the diet of pregnant women, what should the nurse be aware of? 1 Many protein-rich foods are also good sources of calcium, iron, and B vitamins. 2 Many women need to increase their protein intake during pregnancy. 3 As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet. 4 High-protein supplements can be used without risk by women on macrobiotic diet.

1 Good protein sources such as meat, milk, eggs, and cheese also have a lot of calcium and iron. Most women already eat a high-protein diet and do not need to increase their intake. Protein is sufficiently important that specific servings of meat and dairy are recommended. High-protein supplements are not recommended, because they have been associated with an increased incidence of preterm births.

The nursing instructor is teaching a group of students about preconception counseling and care. The student nurse asks the nurse about interventions that can decrease the incidence of spina bifida in the fetus. Which answer does the nurse give to the student? 1 "Include a daily intake of 600 mcg of folic acid during pregnancy." 2 "Eat a well-balanced diet during pregnancy." 3 "Include aerobic exercise regularly during pregnancy." 4 "Focus on methods to maintain a euglycemic condition during pregnancy."

1 The incidence of neural tube defects can be decreased significantly by regular intake of 400 mcg of folic acid supplements during pregnancy. A well-balanced diet helps prevent illness and is used to treat certain health problems, such as hypertension and osteoporosis. Regular exercise is effective in the prevention of cardiovascular disease and in the management of chronic conditions, such as hypertension, arthritis, diabetes, respiratory disorders, and osteoporosis. Maintenance of euglycemia in the patient during pregnancy reduces the rate of congenital anomalies.

When planning a diet with a pregnant woman, what is the nurse's first action? 1 Review the woman's current dietary intake. 2 Teach the woman about MyPlate. 3 Caution the woman to avoid large doses of vitamins, especially those that are fat-soluble. 4 Instruct the woman to limit the intake of fatty foods.

1 Reviewing the woman's dietary intake as the first step will help to establish if she has a balanced diet or if changes in the diet are required. Teaching the woman about MyPlate is correct but the first action is to assess the patient's current dietary pattern and practices because instruction should be geared to what she already knows and does. Cautioning the woman to avoid large doses of vitamins is correct but the first action should be to assess the patient's current dietary pattern and practices. Instructing the woman to limit the intake of fatty foods is correct but the first action should be to assess the patient's current dietary pattern and practices.

Which suggestion about weight gain is an accurate recommendation? Select all that apply. 1 Underweight women should gain 12.5 to 18 kg. 2 Obese women should gain at least 7 kg. 3 Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale. 4 In twin gestations, the weight gain recommended for a single-fetus pregnancy should simply be doubled. 5 The desirable weight gain during pregnancy varies among women.

1,2,3,5 The desirable weight gain during pregnancy varies among women. Underweight women need to gain the most. Obese women need to gain weight during pregnancy to equal the weight of the products of conception. Adolescents are still growing; therefore, their bodies naturally compete for nutrients with the fetus. Women bearing twins need to gain more weight (usually 16 to 20 kg) but not necessarily twice as much.

Which suggestions should the nurse include when teaching about appropriate weight gain in pregnancy? Select all that apply. 1 Underweight women should gain 12.7 to 18.1 kg (28 to 40 lb). 2 Obese women should gain 5 to 9.1 kg (11 to 20 lb). 3 Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale. 4 In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled. 5 Normal weight women should gain 11.3 to 15.9 kg (25 to 35 lb).

1,2,3,5 Underweight women need to gain the most. Obese women need to gain weight during pregnancy to equal the weight of the products of conception. Adolescents are still growing; therefore, their bodies naturally compete for nutrients with the fetus. Women bearing twins need to gain more weight (usually 21 to 28 kg [46 to 62 lb]) but not necessarily twice as much. Normal weight women should gain 11.3 to 15.9 kg (25 to 35 lb).

The nurse is caring for a pregnant patient. What instruction does the nurse give the patient to prevent the risk of fetal neurotoxicity? Select all that apply. 1 "Avoid eating shark." 2 "Avoid eating tilefish." 3 "Avoid eating catfish." 4 "Avoid eating swordfish." 5 "Avoid eating pollock."

1,2,4 Fish is a rich source of omega-3 fatty acids, which are essential for brain development and neurologic functions. High levels of mercury can harm the developing nervous system of the fetus, and certain fish have high mercury content. Pregnant women need to avoid shark, tilefish, and swordfish, because these fish have high levels of mercury. Fish such as catfish and pollock have lower mercury levels, so the patient can consume up to 12 ounces of these fish a week.

A patient who is in the first trimester of pregnancy reports frequent nausea. Which nursing interventions would help relieve the symptoms of nausea in this patient? Select all that apply. 1 Assessing if the patient is well hydrated 2 Assessing the patient's weight gain pattern during pregnancy 3 Reviewing the food frequency approach during pregnancy 4 Reviewing measures already taken for the prevention of morning sickness 5 Discussing food cravings that may occur during pregnancy

1,2,4 Nausea may occur due to morning sickness during the first trimester of pregnancy. To relieve this condition in the patient, the nurse should assess the reasons behind it. Therefore, the nurse is required to assess the patient's state of hydration and pattern of weight gain during pregnancy. The nurse should also find out what measures the patient has taken to relieve morning sickness. Then, the nurse can treat the condition of nausea in the patient. Reviewing the food frequency approach and discussing food cravings that may occur during pregnancy would help prevent nutritional imbalance, because it is possible that the patient is avoiding food for fear of weight gain.

The nurse is caring for a postpartum patient. While reviewing the reports, the nurse finds that the prepregnancy weight of the patient was 60 kg (132.2 lb), and the postpregnancy weight is 80 kg (176.3 lb). For what is the patient at risk in the future? Select all that apply. 1 Hypertension 2 Hypercalcemia 3 Arteriosclerosis 4 Mild ketonemia 5 Diabetes mellitus

1,3,5 Obesity during pregnancy is associated with increased use of health care services and longer hospital stays. Excessive weight gained during pregnancy may be difficult to lose after pregnancy. This contributes to the patient becoming chronically overweight or obese. Obesity is an etiologic factor in a host of chronic diseases, including hypertension, arteriosclerotic heart disease, and diabetes mellitus. Patients who gain 18 kg or more are especially at risk for these chronic diseases. Hypercalcemia may occur due to excess intake of calcium. Mild ketonemia occurs when a pregnant patient restricts her diet for fear of weight gain.

The nurse is conducting an initial history and interview on a new patient who is pregnant. Because certain vitamins are known to cause fetal defects when consumed at toxic levels, which vitamins will the nurse ask the patient if she takes? Select all that apply. 1 A 2 B 3 C 4 D 5 E 6 K

1,4,5,6 Fat-soluble vitamins A, D, E, and K are known to cause fetal defects when intake is at toxic levels. Vitamins B and C are water-soluble and are excreted before they reach toxic levels.

A pregnant woman with a body mass index (BMI) of 22 asks the nurse how she should be gaining weight during pregnancy. What is the nurse's best response in terms of an approximate pattern of weight gain? 1 A pound a week throughout pregnancy 2 Two to 5 lb during the first trimester, then a pound each week until the end of pregnancy 3 A pound a week during the first two trimesters, then 2 lb per week during the third trimester. 4 A total of 25 to 35 lb

2 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 is not the correct guideline during pregnancy. One pound per week during the first two trimesters and 2 lb per week thereafter is not the correct guideline for weight gain during pregnancy. A total weight gain of 25 to 35 lb is correct, but the pattern needs to be explained to the woman.

The nurse is caring for a pregnant patient whose prepregnant body mass index (BMI) is 23.5. Under which BMI category does the nurse categorize the patient? 1 Obese 2 Normal 3 Overweight 4 Underweight

2 A commonly used method of evaluating the appropriateness of weight in terms of height is the BMI. BMI is calculated by using the following formula: BMI = weight/height2. In this formula, the weight is in kilograms and the height is in meters. Prepregnant BMI can be classified as normal if the BMI is in the range of 18.5 to 24.9. If it is less than 18.5, it is classified as underweight or low BMI. If the BMI ranges from 25 to 29.9, it is classified as overweight or high BMI, and if it is greater than 30, it is classified as obese BMI. Because the patient's BMI lies between 18.5 and 24.9, the patient has normal BMI. The patient is not obese, overweight, or underweight.

A women with an inadequate weight gain during pregnancy is at higher risk of giving birth to an infant with which condition? 1 Spina bifida 2 Intrauterine growth restriction 3 Diabetes mellitus 4 Down syndrome

2 Both normal-weight and underweight women with inadequate weight gain have an increased risk of giving birth to an infant with intrauterine growth restriction. Spina bifida is not associated with inadequate maternal weight gain. An adequate amount of folic acid has been shown to reduce the incidence of this condition. Diabetes mellitus is not related to inadequate weight gain. A gestational diabetic mother is more likely to give birth to a large-for-gestational age infant. Down syndrome is the result of a trisomy 21, not inadequate maternal weight gain.

Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with what? 1 Spina bifida 2 Intrauterine growth restriction 3 Diabetes mellitus 4 Down syndrome

2 Both normal-weight and underweight women with inadequate weight gain have an increased risk of giving birth to an infant with intrauterine growth restriction. Spina bifida is not associated with inadequate maternal weight gain. An adequate amount of folic acid has been shown to reduce the incidence of this condition. Diabetes mellitus is not related to inadequate weight gain. A gestational diabetic mother is more likely to give birth to a large-for-gestational age infant. Down syndrome is the result of a trisomy 21, not inadequate maternal weight gain.

The nurse is assessing a 25-year-old pregnant patient and learns the patient is lactose intolerant and avoids consuming any dairy foods. Upon reviewing the patient's daily diet chart, the nurse sees that the patient eats four pieces of French toast and 3 cups of cooked dried beans almost every day. The patient does not consume any other calcium-rich food in the diet. What does the nurse interpret about the patient? 1 The patient consumes sufficient calcium. 2 The patient requires additional calcium. 3 The patient requires calcium from different sources. 4 The patient is consuming too much calcium.

2 Four pieces of French toast and 3 cups of dried beans is equivalent to about 2 cups of milk in terms of the calcium content. Each cup of milk contains approximately 300 mg of calcium, so the patient is getting about 600 mg of calcium daily. The recommended intake of calcium for pregnant women over the age of 19 is 1000 mg/day so the patient is falling short of the daily calcium requirement. The nurse should suggest that the patient add another 400 mg of calcium every day. Because the total calcium requirement is 100 mg and the patient is already getting some calcium, the nurse would not suggest that the patient consume an additional 1000 mg of calcium.

A patient starting her second trimester has not gained the amount of weight necessary for optimal growth and development of the fetus. The patient tells the nurse she is working out vigorously and drinks protein supplement shakes instead of eating protein-rich foods. Which statement from the patient indicates the nurse has supplied the appropriate nutritional education regarding protein needs? 1 "It is fine to use my supplements when working out during my pregnancy, but I need to eat more beef and chicken." 2 "My protein shakes do not include other nutrients I need while I am pregnant, so I must eat more protein-rich foods instead of using protein supplements." 3 "I need to stop using protein shakes and working out until after I have had the baby." 4 "Protein shakes include too many extra minerals that I do not need during pregnancy, so I need to replace them with direct sources of protein, such as chicken and beef."

2 Protein-enriched supplements and shakes do not include other nutrients needed during pregnancy, so it is not recommended to use these as a source of protein and to replace them with protein-rich foods. Protein supplements should not be used, even when working out; however, there is no need to stop exercising unless directed by a physician. Extra minerals in protein shakes are not the reason for replacing with protein-rich foods during pregnancy.

A pregnant woman experiencing nausea and vomiting should do what? 1 Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning. 2 Eat small, frequent meals (every 2 to 3 hours). 3 Increase her intake of high-fat foods to keep the stomach full and coated. 4 Limit fluid intake throughout the day.

2 The correct suggestion for a woman experiencing nausea and vomiting is to eat small, frequent meals (every 2 to 3 hours). A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the day or when nauseated. A pregnant woman experiencing nausea and vomiting should reduce her intake of fried foods and other fatty foods. A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the morning or when nauseated but should compensate by drinking fluids at other times.

The nurse is caring for a pregnant patient with vitamin B6 deficiency. Which food item does the nurse include in the patient's diet to encourage normal fetal development? 1 Yeast 2 Meats 3 Asparagus 4 Strawberries

2 Vitamin B6, or pyridoxine, is the vitamin involved in the metabolism of proteins. So its deficiency may inhibit the development of the fetus. Meats are rich in vitamin B6, so patients with vitamin B6 deficiency are recommended to eat meat. Yeast is rich in vitamin E. Asparagus is rich in folate. Strawberries are rich in vitamin C. Eating yeast, asparagus, or strawberries will not combat vitamin B6 deficiency.

The nurse is caring for a pregnant patient who drinks alcohol. What adverse fetal effects can the nurse expect to discuss with the patient? 1 Postterm delivery 2 Mental retardation 3 Spina bifida 4 Anencephaly

2 Fetal alcohol syndrome (FAS) is a known consequence of prenatal alcohol intake, and other consequences include increased risk for miscarriage, preterm birth, and sudden infant death syndrome. Low birth weight, mental retardation, behavioral problems, learning problems, and physical problems are all symptoms of FAS. Postterm delivery is not typically a problem for pregnant women who use alcohol. Neural tube defects such as spina bifida and anencephaly may be caused by folic acid deficiency in the patient and other factors, but not maternal alcohol consumption.

On assessing the laboratory reports of a patient who is 12 weeks pregnant, the nurse observes that the patient's level of serum ferritin is low. Which condition does the nurse expect in the patient? 1 Tetany 2 Anemia 3 Renal failure 4 Hypertension

2 Women are at an increased risk for iron deficiency during pregnancy. Iron is needed to allow the transfer of adequate iron to the fetus and for the expansion of the maternal red blood cell (RBC) mass. The serum ferritin level is an indicator of iron content in the body. Poor iron status results in iron-deficiency anemia. Tetany occurs due to calcium deficiency. Renal failure may occur due to an imbalance of electrolytes such as potassium and sodium. Hypertension may occur due to high intake of sodium and potassium.

The nurse talks to a patient who maintains a vegan diet about food choices to prevent calcium deficiency. Which foods would the nurse suggest for this purpose? Select all that apply. 1 Cheese 2 Collards 3 Carrots 4 Dried figs 5 Cooked dried beans

2,4,5 The patient is vegan and therefore would not be consuming any dairy products. In order to prevent calcium deficiency in the mother and the fetus, the nurse should suggest that the patient eat non-dairy foods that are good sources of calcium. The patient should consume about 10 to 12 dried figs, which is equivalent to one cup of milk in terms of calcium content. Collards and cooked dried beans are also good sources of calcium. The patient is a vegan, so the nurse should not recommend that the patient consume dairy products such as cheese. Carrots are not a good source of calcium.

The nurse is caring for a pregnant patient whose pre-pregnancy body mass index (BMI) was 20. The patient is in the third trimester and has gained 25 lb. How can the nurse best counsel this patient regarding nutrition? 1 "In order to prevent further weight gain, limit your intake of dietary fats." 2 "You should avoid gaining any additional weight during this pregnancy. Limit your calories to less than 2000 each day." 3 "Your weight is within a healthy range. Continue eating a balanced diet and participating in moderate physical activity." 4 "Although your weight is within a healthy range, because you were overweight prior to the pregnancy, you still need to watch what you eat."

3 A healthy total weight gain range during pregnancy is 25 to 35 lb for patients with a normal prepregnancy BMI. The patient should be counseled to continue eating a balanced diet and participate in moderate physical activity. The patient does not need to be counseled to avoid gaining more weight. Healthy dietary fats are important for both maternal and fetal health. Most pregnant women require a daily caloric intake of 2200 to 2900 calories. The patient's prepregnancy BMI of 20 indicates she was not overweight before the pregnancy.

Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet? 1 Fat-soluble vitamins A and D 2 Water-soluble vitamins C and B6 3 Iron and folate 4 Calcium and zinc

3 Iron generally should be supplemented, and folic acid supplements often are needed because folate is so important. Fat-soluble vitamins should be supplemented as prescribed by the medical provider, because vitamin D might be contraindicated for lactose-intolerant women. Water-soluble vitamin C sometimes is consumed in excess naturally; vitamin B6 is prescribed only if the woman has a very poor diet. Zinc sometimes is supplemented. Most women get enough calcium.

The nurse is caring for a female patient who recently had an abortion after learning that the fetus had a neural tube defect. The patient wants to conceive again and asks the nurse for advice. What suggestion is best to prevent neural tube defects in future pregnancies? 1 "Take 15 mg of iron every day." 2 "Take 46 g of protein every day." 3 "Take 4 mg of folic acid every day." 4 "Take 1300 mg of calcium every day."

3 Neural tube defects are mostly seen in infants of women with poor folic acid intake. The patient has had a previous pregnancy with a neural tube defect in the fetus. In this situation, even when the patient has not conceived again, the patient should be advised to take 4 mg of folic acid every day. This is useful to prevent neural tube defect in subsequent pregnancies. Every woman, whether planning to become pregnant or not, should consume 1300 mg of calcium, 46 g of protein, and 15 mg of iron to meet daily nutritional requirements. However, these micronutrients may not help prevent neural tube defects.

The nurse is reviewing laboratory values for a pregnant Hispanic patient. The patient's hemoglobin value is 9.3 g/dL. What nutritional recommendation would be most appropriate for this patient? 1 Increase corn, beans, and tomatoes. 2 Increase dark leafy green vegetables. 3 Take an iron supplement with fruit juice. 4 Take an iron supplement with a glass of milk

3 The most appropriate nutritional recommendation for this patient is to take an iron supplement with fruit juice. The patient's hemoglobin value indicates a need for increased iron in the diet. Many Hispanic patients avoid iron during pregnancy because both iron and pregnancy are considered "hot." However, taking the iron with something cold, such as fruit juice, is more likely to be implemented. The vitamin C in the fruit juice will also help with iron absorption. Corn, beans, and tomatoes are parts of the traditional Hispanic diet but will not sufficiently address the iron deficiency. Although dark leafy green vegetables are high in iron, they are not often included in Hispanic diets. Many Hispanics are lactose intolerant, and milk is not commonly used.

After assessing the diagnostic reports of a patient who is 9 months pregnant, the nurse notices that the fetus has neural tube defects. What substance might be deficient in the patient? 1 Calcium 2 Proteins 3 Folic acid 4 Cholesterol

3 The embryo and fetus must obtain the necessary nutrients they need from the mother's diet. Decreased folic acid levels in the mother lead to neural tube defects in the newborn. Such defects include those in the brain or spinal cord. Decreased levels of calcium, decreased levels of proteins, or increased levels of cholesterol do not cause neural tube defects in newborns. Decreased levels of calcium and proteins may lead to growth retardation of the fetus. Increased levels of cholesterol in the maternal blood do not affect fetal health.

The nurse is caring for a pregnant patient who is prescribed vitamin A supplements. What does the nurse tell the patient is the reason for not taking more than the prescribed dosage of vitamin A? Select all that apply. 1 To avoid tetany in the newborn 2 To avoid anemia in the newborn 3 To avoid spina bifida in the newborn 4 To avoid cleft palate in the newborn 5 To avoid hypocalcemia in the newborn

3,4 Fat-soluble vitamins, such as vitamin A, are stored in the body tissues. If taken in high doses, these vitamins can reach toxic levels. Due to the high potential for toxicity, pregnant women are advised to take fat-soluble vitamin supplements only as prescribed. Congenital malformations such as spina bifida and cleft palate have occurred in infants whose mothers took excessive amounts of preformed vitamin A (from supplements) during pregnancy. Therefore taking extra supplements in addition to the commonly prescribed prenatal vitamins is not routinely recommended for pregnant women. Tetany in the newborn occurs due to an inadequate supply of calcium. Anemia in the newborn may occur due to an inadequate supply of folic acid. Hypocalcemia occurs due to an inadequate supply of calcium.

The nurse is caring for a pregnant patient in her first trimester with imbalanced nutrition due to nausea and vomiting. What nursing interventions will help maintain appropriate nutrition in the patient? Select all that apply. 1 Advise the patient to rest as needed. 2 Advise the patient to increase fiber in her diet. 3 Advise the patient to consume small and frequent meals. 4 Advise the patient to eat dry crackers first thing in the morning. 5 Advise the patient to contact the primary health care provider if vomiting is severe.

3,4,5 The pregnant patient may eat less than her body requires in the first trimester due to nausea and vomiting. The nurse should advise the patient to eat small and frequent meals to avoid nausea. Eating dry crackers first thing in the morning will help decrease the incidence of vomiting. The nurse should advise the patient to contact the primary health care provider if severe vomiting occurs. The primary health care provider can help identify possible causes of hyperemesis. Resting reduces fatigue in the patient. Encouraging the patient to increase fiber in her diet is an intervention to avoid constipation.

When counseling a patient about getting enough iron in her diet, what should the maternity nurse tell her? 1 Milk, coffee, and tea aid iron absorption if consumed at the same time as iron. 2 Iron absorption is inhibited by a diet rich in vitamin C. 3 Iron supplements are permissible for children in small doses. 4 Constipation is common with iron supplements.

4 Constipation can be a problem when taking iron supplements. Certain beverages, including milk, coffee, and tea, inhibit iron absorption when consumed at the same time as iron. Vitamin C promotes iron absorption. Children who ingest iron can get very sick and even die.

The nurse is caring for an underweight patient with singleton pregnancy. After the first trimester, the nurse observes that the patient's weight gain is approximately 0.3 kg per week. Which risk is the fetus exposed to? 1 Hypoglycemia 2 Hypocalcemia 3 Congenital malformations 4 Intrauterine growth restriction (IUGR)

4 During the first trimester of singleton pregnancy, the average total weight gain is only 1 to 2 kg. Thereafter, the recommended weight gain increases to approximately 0.5 kg per week for an underweight patient. Therefore, the fetus of a pregnant patient who has gained less than 0.5 kg per week may be at risk for IUGR. The fetus is at risk for hypoglycemia if the mother is hypoglycemic. The fetus is at risk for hypocalcemia if the mother has an inadequate amount of calcium in her daily diet during pregnancy. The fetus is at risk for congenital disorders if the mother has impaired nutrition during pregnancy.

The nurse is caring for a pregnant patient who is taking iron supplements. What is the risk of iron supplementation for pregnant women? 1 Tetany 2 Anemia 3 Diabetes 4 Constipation

4 Iron supplements are prescribed to increase the patient's folate levels. Constipation is generally observed in patients who consume iron supplements, so patients are advised to eat a diet high in fiber to relieve constipation. Tetany is caused by vitamin D deficiency. Anemia may be caused by folic acid deficiency. Diabetes is caused by low insulin levels.

A dietician has asked a pregnant patient to eat 12 ounces of fish every day. The nurse advises the patient to avoid fish such as swordfish, tilefish, and king mackerel. Which fetal complication is the nurse trying to prevent by giving this suggestion? 1 Impaired bone development 2 Impaired protein metabolism 3 Impaired hemoglobin formation 4 Impaired neurologic development

4 Swordfish, tilefish, and king mackerel are known to have high mercury content. Consumption of these fish may lead to an increase in serum levels of mercury, which is neurotoxic to the fetus. Impaired bone development may be caused by inadequate calcium and vitamin D intake, but this is unrelated to the consumption of fish. Inadequate consumption of magnesium and vitamin B 6 would result in impaired protein metabolism in the fetus, but this is not directly related to fish consumption. Inadequate intake of iron would result in impaired hemoglobin formation in the fetus.

A patient weighs 60 kg and is 158 cm tall. How does the nurse record the body mass index (BMI) of the patient? Record your answer using a whole number. _____________ kg/m2

BMI is calculated using the formula BMI = weight ÷ height2 where weight is in kilograms (kg) and height is in meters (m). Because the patient weighs 60 kg and is 158 cm tall, the height of the patient in meters is 1.58 because 1 m = 100 cm. Therefore the BMI of the patient is 60 ÷ (1.58)2= 24.29 = 24.3. This would be rounded to 24. A BMI below 24.9 is considered normal.

When counseling a woman about getting enough iron in her diet, what should the maternity nurse tell her? 1 Milk, coffee, and tea aid iron absorption if consumed at the same time as iron. 2 Iron absorption is inhibited by a diet rich in vitamin C. 3 Iron supplements are permissible for children in small doses. 4 Constipation is common with iron supplements.

Constipation is common with iron supplements. Milk, coffee, and tea inhibit iron absorption when consumed at the same time as iron. Vitamin C promotes iron absorption. Children who ingest iron can get very sick and even die.