Examl2:lNURS5333/lNURSl5333l(Latest
lUpdate)lFamilylIl|lQsl&lAs|l100%lCorrect|l
GradelAl(VerifiedlAnswers)
Q:lWhatlarelnutritionallrequirementslduringlpregnancy?lCalories?lFoliclacid?lIron?letc
Answer:
lCalorieslneedltolbelincreasedlbylaboutl300-
kilolcalorieslperlday,0.4lmilligramslperlday,lsomelrecommendlmorelthanlthatloflfoliclacid,lelem
entallironlatlaboutl30lmilligramslalday,landlcalcium,l1200lmilligramslalday.
Q:lWhatlislthelrecommendedlweightlgainlduringlpregnancy?lNormallweight?lOverweight?lU
nderweight?
Answer:
lweightlgainlforlnormal-
weightlfemaleslisl25ltol35lpounds,lunderweightlislaboutl28ltol40lpounds,loverweightlwithlalB
MIlofl25ltol29.9,lislaboutl15ltol25lpounds
Q:lWhatlarelpregnancyldangerlsigns?
Answer:
lanylvaginallbleeding,lswellingloflthelfacelorlfingers,lseverelorlcontinuouslheadache,ldimnesslo
rlblurringloflvision,labdominallorlepigastriclpain,lpersistentlvomiting,lchillslorlfever,ldysuria,les
capeloflfluidlfromlthelvagina,landlmarkedlchangeslinlfrequencylorlintensityloflfetallmovements.
Q:lWhatlarelcommonlcomplaintslduringlpregnancy?lTreatmentlbothlpharma-
lcologiclandlnonpharmacologic?
Answer:
lAnkleledema,ltx:maintainlhydration,ltolelevateltheirllegslandltwicelaldayltheylneedltolrestlforla
nlhourlwithltheirlfeetlhigherlthanltheirlheart,Backache:goodlbodylmechanicslandlgoodlstretchin
glexercises.lrest,lmaintainladequateldietlandloptimallweight,lwearlalpregnancylsupportlbelt,lavo
,idlstraininglandllifting,luselproperlbodylmechanics,lphysicalltherapylcanlhelpldoingllikelIlsaidlp
elvicltiltlexerciseslandlsoftltissuelmassages,lpillowlsupportlduringlsleep,lelevatelthelfeetlwhenlsi
tting,lavoidluncomfortablelworkinglheights,ldon'tlwearlhighlheeledlshoes.lTheylcanlapplylheati
nglpadslorlhotlcompresseslorltakelwarmlbathslandlconsiderlalternativeltherapieslsuchlaslchiropr
actic,lacupuncture,landlacupressure.lAcetaminophen...NOlNSAIDS.lConstipation:>fluids,lfiberl
andlexercise.
Q:lWhatlislhyperemesislgravidarum?lManagement?lheartlburn.
Answer:
lpersistentlintractablelvomitinglthatlleadsltolweightllosslandlelectrolytelimbalancelduringlpreg-
lnancy.heartlburn:lH2lblockerslarelconsideredlsafe,lTumslandlMaaloxlarelconsideredlsafe,landll
ansoprazolelhaslbeenlusedlinlpregnancylandlconsideredlsafeliflalprotonlpumplinhibitorlislindica
ted.lsaltieslbylbed.lginger.Diclegis,lit'slalcombinationlofldoxylaminelandlpyridoxine.lAntihistam
ineslandlphenothyazinelanti-emetics,landlpro-motilitylagents
Q:lWhatlarelsignslandlsymptomsloflectopiclpregnancy?lTheselpatientslneedlreferral.
Answer:
lanylconceptuslthatlimplantslandlgrowsloutsideltheluterinelcavity,lbutlit'slusuallylinltheltube.lab
normalluterinelbleedinglandlit'slusuallylspottinglandlitlmaylbeldarklbrownltoltarrylsolthislislyou
rlcluelherelforlectopiclpregnancylislthatlspottinglthat'sldarklbrownltoltarry.lshoulderlpain.ltender
ladnexalwithlpossiblelpalpablelmass,lthey'lllhavelpositivelcervicallmotionltenderness
l
Q:lWhatlislPregnancylinducedlHTNl(PIH)?lWhatlislPre-
eclampsia,leclampsia,landlHELLPlsyndrome?
Answer:
l(lpreviouslHTNldoeslnotlCount)lbloodlpressurelgreaterlthanl140/90lorlalriselinlsystoliclpressur
eloflgreaterlthanl30lmmHg:lPreclamsialislproteinlinlthelurinel@l20lweekslw/suddenlweightlgai
n,lheadaches,lvisionlissues.lEclampsialislproteinlinlthelurinelandlseizures,lbloodlpressurelislcon
sistently
abovel160/100.They'lllhaveltonic-
cloniclseizures.lHELLP:hemolysis,lelevatedlliverlenzymes,llowlplatelets
Q:lDifferentiatelbetweenlplacentalprevialandlabruptiolplacentae.
,Answer:
lWithlplacen-
ltalprevia,lbleedinglislpainlesslandlnotlanlemergencylbutlAbruptialplacentae:lThislislseparationl
oflthelplacentalfromltheluterinelwalllandlthere'slseverelpainlit'slanlemergency.
Q:lWhatlarelsignslandlsymptomsloflPPD?lWhenlshouldlscreeninglbeldone?lManagementlboth
lpharmacologiclandlnonpharmacologic?
Answer:
lpostpartumlde-
lpressionlaslalmajorldepressionlthatlbeginslaboutlfourlweekslafterldelivery.lTheselwomenlwillla
lsolhavelalchangelinlweightlorlappetite.lTheylfeellworthlesslorlguilty.lTheylmaylhavelthoughtsl
oflharminglthemselveslorltheirlnewborn,landltheylmaylhavelrecurringlthoughtslofldeathlorlsuici
de.lAtleverylpostpartumlvisit,ltheselwomenlshouldlbelscreenedlforlpostpartumldepression.lBrea
stfeedlbaby,lexercise,lrelax,lmassage,lelectrolconvulsantltherapylislallastlresortliflthelantidepress
antslandltherapylarelnotlworking.
Q:lWhatlarelabsolutelcontraindicationsltolbreastlfeeding?
Answer:
linfantlgalac-ltosemia,lHIV-1lorl2lpositivelstatus,lhumanlT-
cellllymphotropiclvirusltypelIlorlIIlinfections,lactiveluntreatedltuberculosis,lbrucellosis,lmaterna
llalcohollandlsub-
lstancelabuselandlherpesllesionslonlthelmother'slbreastltouchinglmilk.maternallantimetabolites,l
chemotherapy,lradioactiveltherapy,lcontraindicatedlmaternallmed-
lications,lEbolalinfectionlandlMarburglhemorrhagiclfever.
Q:lWhatlareladvantages?lDisadvantages?Breastfeeding
Answer:
lpreventlpostpartumlhemorrhage,ltriggerslalletdownlreflexlforlthelmilklrelease,lItlcalms,lreduces
lstresslandlpromoteslbondinglforlthelmotherlandlthelinfant.
Q:lWhatlislcolostrum?lTransitionallmilk?lMaturelmilk?
Answer:
, lColostrumlislthelthick,lstickylyellowlfluidlrichlinlimmunoglobulins,lvitaminlElandlleukocytes.l
whichlislthinnerlandlmorelplentiful.lItlhaslincreasedllactose,lfat,lcalorieslandlwater-
solublelvitaminlcontentlandlislsecretedltwoltolfiveldayslafterldeliverylupluntillaboutl10ltol14lda
ys.lmaturelmilklcomeslinlandlthislconsistsloflthelforemilk,lwhichlislfirstlmilklexpressedlfromlth
elbreastlatleachlnursing,landlhindmilk,lwhichlislhigherlinlfatlandlcalories.
Q:lWhatlarelnutritionlrequirements?lNutritionlrequirementslforlbreastfedlinfants?
Answer:
lWomenlneedlaboutl1900ltol2500lkilocalorieslperlday.lThisldependslonlprepregnancylweightlan
dlweightlgainlduringlpregnancy,lbutlwomenldon'tlwantltolstartlrestrictinglcaloriesltolloselthelba
bylweightluntillatlleastltwolmonthslintolthe
l
breastfeeding.lIronl27lmglperlday.lThelfetuslstoreslareladequatelforlthelfirstlfewlmonths,lbutlth
enlironlsupplementslhaveltolbelgivenltolthelfetus.lFoliclacidl600lmicrogramslperlday.lCalciuml
1000lmglperlday.lIodinel200lmglperlday,lCholine,laboutl450lmglVitaminlA,l770lmglperlday.lVi
taminlB,lvitaminlC,laboutl85lmglperlday.lConsiderlalmultivitaminlandlDHAlsupplementationlf
orlvegans,lvegetarianslorlundernourishedlwomen.lPrenatallvitaminslarelalgoodlsupplementationl
during
breastfeeding.lRememberlthatlthey'relmostleffectivelifltakenlwithljuicelorlwater,landlthatltakingl
themlwithlmilklorltealreduceslthelironlabsorption
Q:lWhatlcanlbreastfeedinglmomldoltoldecreaselriskltolthelinfantlwhenltakinglmedications?l(s
eelPLLRllecturel1)
Answer:
lTheldrugslneedltolbeltakenlimmediatelylafterlbreastfeeding,lavoidlanyldrugslthatlhavellonglhal
f-
lives,lchooseldrugslthatltendltolbelexcludedlfromlmilklandlthatlarelleastllikelyltolaffectlthelinfa
nt,landlavoidldrugslthatlarelknownltolbelhazardous.lAndlthislincludeslsmokinglnicotine.
Q:lWhatlshouldlyoultelllmomlaboutlETOHluselandlsmokinglduringlpregnan-lcy?
Answer:
lnotlbeldonelinlpregnancy.lAfterlonelstandardldrinkloflalcohol,l175lminuteslhaveltollapselbefor
elthelbreastlmilklreturnsltolzerolalcoholllevel.lSmokinglcessationlislhighlylrecommended:Smoki
nglreduceslprolactinllevelslandlmilklvolume.lItlimpairsltheltaste,lcompositionlandlprotectivelpro
pertiesloflthelbreastlmilk.lNicotinelislalsolexcretedlinlthelbreastlmilklandlcontainslthreeltimeslth
elamountloflnicotinelaslthelmother'sllevels.lSecondhandlsmokelorlsmokinglwhilelbreastfeedingl
