Nutrition - Pregnancy: Nursing

During pregnancy. The patient and growing fetus require a variety of macro and micro nutrients and increased caloric intake to support sufficient weight gain and development.

Extra calories are needed during pregnancy to supply the energy needed to fuel the increased maternal basal metabolic rate and to support the production and maintenance of maternal tissues, placenta, and fetus.

These calories should primarily come from nutrient dense foods like vegetables, meats, dairy products, legumes and nuts.

Instead of empty calories like fast food, cookies, cakes and sweetened beverages, macronutrients are needed by the body in large amounts and include carbohydrates, fats and proteins.

Carbohydrates are the primary source of calories used for energy. Carbohydrates can be simple like the sucrose found in fruits or complex which are found in sources of starch like legumes, pasta, sweet potatoes and whole grains.

In addition to providing calories, complex carbohydrates contain additional nutrients like vitamins, minerals and fiber.

Fiber is the nondigestible part of carbohydrates that provide bulk to stool to help prevent constipation, which commonly occurs during pregnancy due to hormonal changes that slow the motility of the intestines.

Next fats provide calories and fat soluble vitamins. Good sources of fats include nuts seeds, oils, meats and dairy products, fats also supply fatty acids that help with fetal neurological and visual development such as alpha linolenic acid found in flax seeds, linoleic acid found in vegetable or canola oils and docosahexanoic acid found in cold water.

Fish like salmon. Lastly, proteins are needed for essential processes like building and repairing tissue making enzymes used in metabolic processes and maintaining fluid balance.

Proteins can also be used for energy when other sources aren't available. Some sources of protein include eggs, legumes, tofu nuts, meats and fish, moving on to micronutrients.

These refer to vitamins and minerals that are needed in smaller quantities. Fat soluble vitamins include AD E and K.

While water soluble vitamins include Vitamin C and B. Vitamins like folic acid, folic acid or folate is especially important in pregnancy because it helps to prevent neural tube defects like spina bifida and can be found in foods like beans, whole grains and dark green leafy vegetables.

Minerals that are especially important during pregnancy include iron, calcium, sodium and iodine. Iron is required for the additional hemoglobin contained in the expanded blood supply.

Calcium supports mineralization of fetal teeth and bones. Sodium helps support the increased circulating volume and iodine is needed for fetal neurodevelopment.

When caring for your pregnant patient, assess their nutritional status and provide education, begin by obtaining their height and weight and continue to track their weight gain.

With each visit, then gather information about your patient's knowledge of nutritional needs during pregnancy and ask about their appetite, normal eating habits, special diets such as a vegetarian or vegan diet and food preferences.

Be sure to ask about unusual food cravings which could be related to PCA A craving for nonfood items like dirt or ice chips, which could lead to nutritional deficits.

Also obtain a recent diet history like a three day recall to ensure your patient's daily nutritional intake is adequate and ensure your patient is taking their prescribed prenatal vitamins.

If your patient has nutritional deficits, due to a lack of financial resources, refer them to the social worker. If they report difficulty managing their nutrition, refer them to the registered dietician, then review some dietary precautions they should be aware of during pregnancy.

Teach them that it's safe to eat some types of fish like salmon pollock and sole 2 to 3 times each week. But caution them about eating certain fish like swordfish and mackerel that tend to be higher in mercury, which can adversely impact fetal central nervous system development.

Also let them know they can reduce the risk of infection with listeria monocytogenes, which can lead to spontaneous abortion, preterm, labor or stillbirth by avoiding unpasteurized milk and juices.

Raw meat, poultry and eggs and products from deli counters like lunch meats and prepared salads. Likewise teach them to wash all fruits and vegetables properly to reduce the risk of toxoplasmosis.

A parasite that can cause blindness or mental disability in the newborn. All right.

As a quick recap during pregnancy, the patient and growing fetus require a variety of macro and micro nutrients along with an increased caloric intake to support sufficient weight gain and development.

Nursing considerations include assessing nutritional status and providing education.