NUR 2633 Exam 1 Study Guide
Concept Guide for Week 3 test-chapters: 2, 3, 4, 5, 6, 7, 8, 9, 10, 11
Nutrition in all 3 trimesters
o special needs diets
caloric intake increases only slightly and requires only a 300 kcal/day increase
from prepregnant needs. (normal ranges from 1200-2400 cal/day)
In the first trimester, the average maternal weight gain is 1 to 2.5 kg, and
thereafter the recommended weight gain for a woman of normal weight is
approximately 0.4 kg per week. For overweight women, the recommended
weekly weight gain during the second and third trimesters is 0.3 kg; for
underweight women, it is 0.5 kg.
Dairy products are a great source of protein and include eggs, milk, cheese, and
yogurt. Other protein sources: soy milk and soy cheese, beans, legumes, peanut
butter
Calcium is essential for maintaining bone and tooth mineralization and
calcification. During pregnancy, calcium must be available to the fetus for the
growth and development of the skeleton and teeth.
Calcium foods: dairy, legumes, dark green leafy vegetables, dried fruits, and
nuts.
o vitamins pregnancy
calcium requirement: 1,300 mg/day
Vit D requirement: 600 IU (15mcg)
The iron RDA for prepregnant women ages 14 to 18 is 15 mg/day, for women
age 19 and older, 18 mg/day, and for pregnant women, this amount increases
to 27 mg/day, starting by 12 weeks of gestation
o Fluid intake recommendations
pregnant women should have an intake of eight to ten (8-oz) glasses of fluid per
day.
o Folic acid
Increased estrogen alters the absorption and metabolism of folic acid,
producing susceptibility for folic acid deficiency. Folic acid deficiency can cause
neural tube defects (NTDs), including spina bifida, cleft lip and palate, and
anencephaly.
folic acid helps to regulate red blood cell development and facilitates the
oxygen-carrying capacity of the blood, produces DNA and RNA and helps to
maintain normal brain function and to stabilize mental and emotional health.
minimum of 800 mcg/day of folic acid is recommended
Page 1
, Foods that are rich in folic acid include dark leafy greens, asparagus, broccoli,
citrus fruits, beans, peas and lentils, avocado, okra, Brussels sprouts, seeds and
nuts, fortified breakfast cereals, and calf liver.
Prenatal
o 1st movements
AKA ‘quickening’, usually felt by the mother between 17-20 weeks
o domestic abuse
During pregnancy, the reported incidence of physical abuse ranges from 4% to
30% (CDC, 2013a), and up to 45% of victims of intimate partner abuse before
pregnancy continue to be abused during the pregnancy
Ask if mother feels safe going home
Always report suspected abuse
o recreation drug use
Women may use a number of defenses to emotionally deal with abuse. One
method may involve the use of recreational drugs. it is estimated that
approximately 3% of pregnant women use nonprescription drugs such as
cocaine, amphetamines, heroin, marijuana, or ecstasy. Illegal or recreational
drug use can have a number of detrimental effects on maternal and fetal health
during pregnancy-see chart below:
o
Page 2
, o nausea and vomiting
Nausea and vomiting of pregnancy, or “morning sickness,” occurs because of
high levels of hCG and relaxation of the stomach, esophagus, and
gastroesophageal sphincters.
o hormonal changes
Estrogen and progesterone are the major hormones produced by the placenta
during pregnancy. The effect of estrogen is one of “growth”; the effect of
progesterone is one of “maintenance.”
Estrogen prompts hyperplasia and hypertrophy (growth of cells in number and
size) during pregnancy. Because of the effects of estrogen, breast tissue
enlarges and becomes functional and the uterus expands, a process that allows
for stretching of the muscles to accommodate the growing fetus. Estrogen also
enhances uterine contractility to prepare the muscles for labor.
Progesterone enables the pregnancy to thrive by its relaxation effect on the
smooth muscle. Progesterone causes vasodilation and an increased blood flow
to all body tissues, it slows the gastrointestinal tract to ensure absorption of
essential nutrients for fetal development, and it relaxes the uterine muscle to
prevent the onset of labor until term.
o Fundal heights
Fundal height should match the woman’s gestational age. Example: if she is 17
weeks pregnant fundal height should measure 17cm
o Chadwick's sign: discoloration, or bluish purple hue, that appears on the cervix, vagina,
and vulva-early sign of pregnancy
o Goodell's sign: cervical softening
o Signs and symptoms that a women should report
1st trimester: Severe vomiting, Abdominal cramping and vaginal spotting or
bleeding, any signs of infection- chills, fever, malaise, and anorexia, burning on
urination
2nd tri: headache, vision changes, elevated blood pressure, edema, change in
vaginal discharge, uterine contractions, absence of fetal movements
3rdtri: vaginal bleeding with or without abdominal pain, uterine contractions,
absence of fetal movements
o Cardiovascular changes
As growth of the fetus exerts pressure on the diaphragm, the maternal heart is
pushed upward and laterally to the left
Page 3
Concept Guide for Week 3 test-chapters: 2, 3, 4, 5, 6, 7, 8, 9, 10, 11
Nutrition in all 3 trimesters
o special needs diets
caloric intake increases only slightly and requires only a 300 kcal/day increase
from prepregnant needs. (normal ranges from 1200-2400 cal/day)
In the first trimester, the average maternal weight gain is 1 to 2.5 kg, and
thereafter the recommended weight gain for a woman of normal weight is
approximately 0.4 kg per week. For overweight women, the recommended
weekly weight gain during the second and third trimesters is 0.3 kg; for
underweight women, it is 0.5 kg.
Dairy products are a great source of protein and include eggs, milk, cheese, and
yogurt. Other protein sources: soy milk and soy cheese, beans, legumes, peanut
butter
Calcium is essential for maintaining bone and tooth mineralization and
calcification. During pregnancy, calcium must be available to the fetus for the
growth and development of the skeleton and teeth.
Calcium foods: dairy, legumes, dark green leafy vegetables, dried fruits, and
nuts.
o vitamins pregnancy
calcium requirement: 1,300 mg/day
Vit D requirement: 600 IU (15mcg)
The iron RDA for prepregnant women ages 14 to 18 is 15 mg/day, for women
age 19 and older, 18 mg/day, and for pregnant women, this amount increases
to 27 mg/day, starting by 12 weeks of gestation
o Fluid intake recommendations
pregnant women should have an intake of eight to ten (8-oz) glasses of fluid per
day.
o Folic acid
Increased estrogen alters the absorption and metabolism of folic acid,
producing susceptibility for folic acid deficiency. Folic acid deficiency can cause
neural tube defects (NTDs), including spina bifida, cleft lip and palate, and
anencephaly.
folic acid helps to regulate red blood cell development and facilitates the
oxygen-carrying capacity of the blood, produces DNA and RNA and helps to
maintain normal brain function and to stabilize mental and emotional health.
minimum of 800 mcg/day of folic acid is recommended
Page 1
, Foods that are rich in folic acid include dark leafy greens, asparagus, broccoli,
citrus fruits, beans, peas and lentils, avocado, okra, Brussels sprouts, seeds and
nuts, fortified breakfast cereals, and calf liver.
Prenatal
o 1st movements
AKA ‘quickening’, usually felt by the mother between 17-20 weeks
o domestic abuse
During pregnancy, the reported incidence of physical abuse ranges from 4% to
30% (CDC, 2013a), and up to 45% of victims of intimate partner abuse before
pregnancy continue to be abused during the pregnancy
Ask if mother feels safe going home
Always report suspected abuse
o recreation drug use
Women may use a number of defenses to emotionally deal with abuse. One
method may involve the use of recreational drugs. it is estimated that
approximately 3% of pregnant women use nonprescription drugs such as
cocaine, amphetamines, heroin, marijuana, or ecstasy. Illegal or recreational
drug use can have a number of detrimental effects on maternal and fetal health
during pregnancy-see chart below:
o
Page 2
, o nausea and vomiting
Nausea and vomiting of pregnancy, or “morning sickness,” occurs because of
high levels of hCG and relaxation of the stomach, esophagus, and
gastroesophageal sphincters.
o hormonal changes
Estrogen and progesterone are the major hormones produced by the placenta
during pregnancy. The effect of estrogen is one of “growth”; the effect of
progesterone is one of “maintenance.”
Estrogen prompts hyperplasia and hypertrophy (growth of cells in number and
size) during pregnancy. Because of the effects of estrogen, breast tissue
enlarges and becomes functional and the uterus expands, a process that allows
for stretching of the muscles to accommodate the growing fetus. Estrogen also
enhances uterine contractility to prepare the muscles for labor.
Progesterone enables the pregnancy to thrive by its relaxation effect on the
smooth muscle. Progesterone causes vasodilation and an increased blood flow
to all body tissues, it slows the gastrointestinal tract to ensure absorption of
essential nutrients for fetal development, and it relaxes the uterine muscle to
prevent the onset of labor until term.
o Fundal heights
Fundal height should match the woman’s gestational age. Example: if she is 17
weeks pregnant fundal height should measure 17cm
o Chadwick's sign: discoloration, or bluish purple hue, that appears on the cervix, vagina,
and vulva-early sign of pregnancy
o Goodell's sign: cervical softening
o Signs and symptoms that a women should report
1st trimester: Severe vomiting, Abdominal cramping and vaginal spotting or
bleeding, any signs of infection- chills, fever, malaise, and anorexia, burning on
urination
2nd tri: headache, vision changes, elevated blood pressure, edema, change in
vaginal discharge, uterine contractions, absence of fetal movements
3rdtri: vaginal bleeding with or without abdominal pain, uterine contractions,
absence of fetal movements
o Cardiovascular changes
As growth of the fetus exerts pressure on the diaphragm, the maternal heart is
pushed upward and laterally to the left
Page 3
