Module 6
A nurse is reviewing nutritonal supplementation for pregnant women. Which minerals and vitamins should the nurse identify as being recommended? A. Iron and folate B. Fat-soluble vitamins A and D C. Calcium and zinc D. Water-soluble vitamins C and B6
A Iron generally should be supplemented, and folic acid supplements often are needed because folate is so important. Fat-soluble vitamins should be supplemented as a medical prescription, as vitamin D might be 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 is sometimes supplemented; most women get enough calcium.
Which client statement indicates to the nurse that the she understands her pre-pregnancy instructions? A. "I will take 2000 mg of vitamin C daily." B. "I will take 400 mcg of folic acid daily." C. "I will take an extra 2000 IU of vitamin D." D. "I will increase my intake of calcium to 250 mg/day."
B An increase of folic acid to 400 mcg daily helps prevent neural tube defects. The recommended dose of vitamin C is 85 mg, vitamin D is 1000 mg, and calcium is 1000 to 1300 mg
A nurse observes a pregnant woman experiencing nausea and vomiting. What intervention should the nurse suggest to the client? A. Limit fluid intake throughout the day B. Increase her intake of high-fat foods to keep the stomach full and coated. C. Eat small, frequent meals (every 2 to 3 hours). D. Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.
C Eating small, frequent meals is a correct suggestion for a pregnant woman experiencing nausea and vomiting. She should avoid consuming fluids early in the day or when nauseated, but should compensate by drinking fluids at other times. She should also reduce her intake of fried foods and other fatty foods.
The nurse observes that an antepartum client who is on bed rest for preterm labor is eating ice rather than the food on her breakfast tray. The client states that she has a craving for ice and then feels too full to eat anything else. What is the best nursing action? A. Remove all ice from the client's room. B. Ask the client what foods she might consider eating. C. Remind the client that what she eats affects her baby. D. Notify the health care provider.
D The health care provider should be notified when a client practices pica (craving for and consumption of nonfood substances). The practice of pica may displace more nutritious foods from the diet, and the client should be evaluated for anemia. Option A is overreacting and may be perceived as punishment by the client. Option B allows the dietary department to customize the client's tray but fails to address physiologic problems associated with not consuming nutritious foods in pregnancy. Option C is judgmental and blocks further communication.
The nurse is assessing a pregnant at 16-year-old client. Which factors associated with adolescent pregnancy with the nurse consider when developing a care plan for this client? Select all that apply A. Higher rate of postpartum depression B. Inappropriate dietary choices C. Higher rate of anemia D. Incomplete bone mass E. Under developed secondary sex characteristics
ABCD Adolescence have higher rates of postpartum depression than older women. Important aspect of nursing care for pregnant adolescents is to engage with them during the pregnancy and provide a supportive, welcoming environment and to develop a network of community resources supportive of pregnant and parenting teens to address their psychosocial issues. Adolescents May have an adequate diet and eat more fast foods. The diet is generally high in fats and carbohydrates and efficient in protein, calcium, fruits, and vegetables. Anemia is more common in teens and intensive nutritional evaluation and counseling is indicated. Peak bone mass is reached in the late teens or early 20s. When a teen is pregnant. Higher levels of calcium are required to both provide support for the pregnancy and to support the teens on bone health. Secondary sex characteristics appear early and are complete by the end of puberty: if the adolescent is pregnant, she has completed puberty
Which of these statements about pregnancy in the adolescent population are true? Select all that apply A. Pregnant adolescents often seek less prenatal care B. Infants of teen mothers are at risk of delivering babies late C. Adolescent mothers need competent daycare of their infants D. Infant of adolescent mothers are at increased risk for prematurity E. Fetuses of adolescent mothers are at higher risk for chromosomal defects
ACD Pregnant adolescents are less likely to seek out prenatal care. Adolescent mothers need competent daycare for their infants. Infants born to teen pregnancies are a risk for being born prematurely. Pregnancies and older mothers are at greater risk for chromosomal defect
Which client statement indicates that she understands the instructions of breastfeeding her newborn? (Select all that apply.) A. "Breastfeeding my infant consistently every 3 to 4 hours decreases the likelihood of me ovulating." B. "Breastfeeding my baby immediately after drinking alcohol is safer than waiting for the alcohol to clear my breast milk." C. "I should avoid foods that usually give me gas." D. "When I take a warm shower after I breastfeed, it relieves the pain from being engorged between breastfeedings." E. "When I feed my baby, I should start on the breast the baby stopped on last." F. "I should drink fluids when breastfeeding my baby, especially at night."
ACEF Continuous breastfeeding on a 3- to 4-hour schedule during the day will cause a release of prolactin, which will suppress ovulation and menses, but is not completely effective as a birth control method. Option B is incorrect because alcohol can immediately enter the breast milk. Gas forming vegetables, such as broccoli and onion, can cause the baby to have gases. Taking a warm shower will stimulate the production of milk, which will be more painful after breastfeedings. Baby's will breastfeed until satisfied, which may not empty the second breast and increase the risk for mastitis if breasts are not emptied. Drinking fluids help establish supply of breast milk.
During a prenatal visit, the nurse discusses with a pregnant client the effects of smoking on the fetus. Which statement is most characteristic of an infant whose mother smoked during pregnancy? A. Lower Apgar score recorded at delivery B. Lower initial weight documented at birth C. Higher oxygen use to stimulate breathing D. Higher prevalence of congenital anomalies
B Smoking is associated with low-birth-weight infants. Therefore, mothers are encouraged not to smoke during pregnancy. Options A, C, and D have not been clearly associated with smoking during pregnancy, but there is a strong correlation between smoking and lower birth weights.
A client who is 3 days postpartum and breastfeeding asks the nurse how to reduce breast engorgement. Which instruction should the nurse provide? A. Avoid using the breast pump. B. Breastfeed the infant every 2 hours. C. Reduce fluid intake for 24 hours. D. Skip feedings to let the sore breasts rest.
B The mother should be instructed to attempt feeding her infant every 2 hours while massaging the breasts as the infant is feeding. If the infant does not feed adequately and empty the breast, using a breast pump helps extract the milk and relieve some of the discomfort. Dehydration irritates swollen breast tissue. Skipping feedings may cause further engorgement and discomfort.
Which factor accounts for the greatest portion of weight gain during pregnancy? A. Fetal growth B. Fluid retention C. Metabolic alterations D. Increased blood volume
B Weight gain during pregnancy averages 25 to 35 lb (11.3-15.9 kg). Of this amount, the fetus accounts for 7 to 8 lb (3.2-3.6 kg), or approximately 3096. Fluid retention accounts for 209% to 25% of weight gain. Metabolic alterations do not cause weight gain. Increased blood volume accounts for 129% to 169%6 of weight gain.