Vital Signs and Labs
● Fetal Heart Rate
○ Nml FHR: 110-160 bpm
○ Can be detected as early at 12 weeks on Doppler
● Orthostatic Hypotension
○ Determined when taking 3 blood pressure readings (laying -> sitting -> standing
position)
○ A drop of 20 mmHg in systolic measure wit...
Practice Questions
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Nutrition
Vital Signs and Labs
● Fetal Heart Rate
○ Nml FHR: 110-160 bpm
○ Can be detected as early at 12 weeks on Doppler
● Orthostatic Hypotension
○ Determined when taking 3 blood pressure readings (laying -> sitting -> standing
position)
○ A drop of 20 mmHg in systolic measure within 2 to 5 minutes of standing
● Specific Gravity
○ Used to determine the concentration of urine on a urine dipstick
○ Nml: 1.005-1.030
■ > 1.030 high concentration (could indicate dehydration)
○ Value is usually highest in the morning
● Maternal Lab Values
Optimal Weight Gain in Pregnancy Based on BMI
● Could use either graph. Mcdonald said she will pick a BMI within ranges for both.
, ● 1st Trimester
○ Expected weight gain ranges from 1.1-4.4 pounds
● 2nd and 3rd Trimesters
○ Approx. 1 pound a week
● Underweight and Teenage
○ Recommended to gain slightly more
● Normal
○ Diet that limits to 2000 calories/day is not recommended
○ 300 calorie increase over her nonpregnant state per day is sufficient
○ 500 calorie increase over her nonpregnant state (or an additional 200 calories)
per day is recommended if she decides to breastfeed
● Overweight
○ Recommended to gain slightly less
Risk factors for poor nutrition
● Maternal parity and close intervals in between pregnancy
● Hx of eating disorder
● Hx of anemia in previous pregnancies
● Picca
● Eating foods that have the potential to give a food-borne illness
Fruits
● 2-4 servings per day
Grains
● 6-11 servings per day
● Prevents body from using protein as an energy source
● Promotes growth of the fetus, placenta, and maternal tissues
Protein
, ● 3 servings per day
○ Each serving is 2 oz
● 14 grams over non-pregnant levels
● Sources of protein
○ Lean meats, poultry, eggs, dairy, soy milk/milk products
● Vegan Diet
○ Make sure they are getting complete proteins (sources that contain an adequate
proportion of all 9 essential amino acids)
■ Beans + rice
■ Peanut butter + whole wheat bread
■ Whole grain cereal + soy milk
Folic Acid
● 400 micrograms per day for all women of childbearing age
● Preconception folic acid is important to reduce the risk of NTDs
○ Occur 2nd-4th week post conception
● Sources of folic acid
○ Animal liver*
○ Fresh green leafy vegetables
○ Peanuts
○ Yeast preparations
○ Whole grain breads/cereals
○ Fruits especially citrus (i.e oranges, lemons, grapefruit)
Calcium
● 4 servings (or 1000mg) per day
● 3rd trimester: fetus begins to mineralize their bones and putting them into a reserve to
use after they are born
● Pregnant teens
○ Require more than 1000mg per day
○ Teen years are when women store the most calcium in their bones to last a
lifetime
● Sources of calcium
○ Dairy
○ Dried fruits (i.e. figs and raisins)
○ Dark leafy green vegetables
○ Fish (i.e. sardines, canned salmon with bones)
○ Nuts (i.e. almond and brazil nuts)
○ Soy products fortified with calcium
Sodium
, ● Season to taste when cooking
● No added table salt
● Avoid excessively salty foods
● The body needs salt for adequate placental perfusion
Iron
● Sources of iron
○ Lean meat, dark leafy greens, eggs (esp. egg yolk)
○ Whole grains and enriched breads/cereals
○ Dried fruits
○ Legumes
○ Shellfish
○ Molasses
● Absorption is higher for animal products
● Absorption for non-animal products can be improved when taking with Vitamin C
● Fetus stores iron to be used 4-6 months after birth while strictly breastfed
● How to take
○ After a meal if experiencing GI discomfort
○ Increase fluids and fiber to avoid constipation
○ May cause black stools
○ Milk, coffee, and tea reduce absorption
Fluids
● 8-10 8oz servings/day
○ At least half should be water
● Limit caffeine to 200 mg
○ For reference a grande cup of Pike Place roast coffee from Starbs is 310mg
● Sodas should be in moderation
○ “Empty calories” with no nutritional value
Disordered Eating
● Women with bulimia are more likely to become pregnant than women with anorexia
○ Anorexia can cause amenorrhea due to lack of body fat
● Body image issues
● Feeding the baby
○ Disordered eating may transfer to the eating habits of the baby
○ The mother may go as far as weight the baby before and after feeding or track
the ounces of milk the baby is consuming per day
Pica
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