NUTR 2050 Chapter 7: Chapter 7.docx

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aquamarinesquirrel747

10 Apr 2012

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Usually caused by the mother not pumping or breastfeeding enough or a poor latch while pumping. Fenugreek, goat"s rue and milk thistle are common herbal galactogogues which can increase milk supply but they are not. Fda approved and studies have not been done on the effectiveness. Oral contraceptives with estrogen may decrease milk supply. Metoclopramide is the most commonly used drug to increase milk supply, may cause side effects such as fatigue, drowsiness and diarrhea, can also increase depression, anxiety, confusion and dizziness or headache. Domperidone is commonly used outside of the u. s. , it is not approved by the fda. 90-99% of breastfeeding women receive some type of medication in the first week postpartum, most medications are excreted in the breast milk. Infant"s ability to absorb, detoxify, and excrete the agent. Infant"s age, feeding pattern, total diet and health. The breastfeeding and human lactation study center at the university of rochester always updates its knowledge of more than 3000 drugs.

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QUESTION 1

Indications that an infant is getting enough food are

		six to eight wet diapers/day.
		one bowel movement/day.
		infant is alert and happy.
		any of the above.

QUESTION 2

The recommendation for folic acid is

		about 400 micrograms/day.
		necessary to prevent neural tube defects.
		lower than the RDA.
		a and b.

QUESTION 3

Cow's milk can be given after what age?

QUESTION 4

The risk associated with teenage pregnancy is a

		low-birthweight infant.
		high-birthweight infant.
		low incidence of miscarriage.
		high incidence of gestational diabetes.

QUESTION 5

The recommended order of introducing fruits and vegetables toinfants

		doesn't seem to matter.
		is fruits then vegetables.
		is vegetables then fruits.
		is to mix them together at the same meal.

QUESTION 6

Stress in the mother who breastfeeds has been shown to

		inhibit the quality of milk produced.
		cause greater milk production.
		inhibit the let-down reflex.
		cause weight loss in the infant.

QUESTION 7

Compared to breast feeding women, formula feeding women

		have identical nutrient needs.
		have fewer nutrient needs.
		need more water.
		need less water.

QUESTION 8

Supplementation of folic acid is known to prevent

		eclampsia in pregnant women.
		gestational diabetes in pregnant women.
		spina bifida and other neural tube defects.
		pregnancy-induced hypertension.

QUESTION 9

Breastfed infants need an additional iron source

		after they've been weaned.
		at about six months.
		at three months.
		they don't - they get enough iron from breast milk.

QUESTION 10

A woman who is not breastfeeding

		has the same nutrient requirements as non-lactating women.
		needs more nutrients than non-lactating women.
		has the same nutrient requirements as lactating women.
		has a greater need for water than lactating women.

emeraldhare78

1. How does prenatal body weight influence theamount of weight a woman should gain during pregnancy?

2. At what week of gestation does the embryonicperiod begin? When does the fetal period begin? When is the mostlikely time a teratogen can do the most damage, during theembryonic or fetal period?

3. What risks are there to a baby if the mothergains too little weight during the pregnancy? What risks are thereto a baby if the mother gains too much weight during thepregnancy?

4. What is the relationship between mercury,fish and pregnancy?

5. What are some of the common gastrointestinaldistresses pregnant women experience? What remedies are availableto manage them?

6. What is fetal alcohol syndrome? How can itbe prevented? When can it be most accurately diagnosed?

7. How does the MyPlate food guidance systemsupport a healthy pregnancy?

8. Why is a prenatal dietary supplementrecommended throughout pregnancy?

9. What benefits are there to exercising duringpregnancy? How should exercise be modified during eachtrimester?

10. What is one of the best ways to trackgrowth in children? What are you looking for when you trackgrowth?

11. What benefits to the infant are provided bybreastfeeding?

12. What benefits to the mother are provided bybreastfeeding?

13. What nutrients are vital for supportingdental health in infants and children?

14. Although breast milk has advantages overformula, breastfeeding not recommend if the nursing mother haswhich conditions?

15. At what age is it safe to switch fromformula or breast milk to cowâs milk?

16. Which solid foods should be introducedfirst and at what age and why: cereals, vegetables, andfruits?

17. Do infants have the same AMDRs as adults?If not, how are they different? Is the grams/kg body weight forprotein higher or lower for an infant compared to a teenager oradult?

18. Does eating sugary foods lead tohyperactivity in children? If not, what does?

19. What is the division of responsibilitybetween caregivers and children for feeding?

20. How would you outline a healthy dailyschedule and meal/snack pattern to follow for a preschooler and aschool-aged child?

21. Can the MyPlate tool support childhoodnutrition? How? What other tools can be used?

22. What are the consequences of obesity inchildhood? How can childhood obesity be prevented?

23. How can food allergies be prevented andmanaged in childhood?

24. The rapid weight gains that girlsexperience during adolescence begin at what ages? Forboys?

25. Are the AMDR guidelines for adults the sameas for teenagers? What are these guidelines? (Percent calories fromfat? Carbohydrate? Protein?)

26. Why are calcium and iron the most importantminerals for teenagers? Does gender make a difference?

27. If teens are overweight and it isunrealistic to believe they will grow into their current weight?What rate of weight loss is recommended in terms of pound(s) perweek?

28. Describe the typical diets of teens thatsmoke?

29. What is the nutritional consequence alcoholfor teens?

30. Adolescences should be physically activefor how many minutes/day?

31. How does body composition change over theyears? Is there anything one can do to affect this change?

32. Does Basal metabolic rate increase ordecrease with age? Why? Will the elderly need more or fewercalories per kilo body weight than those who are middleaged?

33. Do the elderly need more or less fluid percalorie intake than younger adults? Why?

34. If an elderly person has osteoporosis, canhe or she do anything to improve this condition?

35. How can a poverty-stricken older adult beassured of eating healthy meals on a regular basis?

36. Why is exercise important for theelderly?

37. How many calories are there in a gram ofalcohol? Why does consuming 2 alcoholic drinks in a man has thesame physiological affect as one drink for a woman?

38. What practices will decrease the rate ofalcohol absorption into the blood?

39. Define moderate alcohol intake in terms ofdrinks per day for men and women and say how it relates to HDLcholesterol.

viridianleopard15

You are the charge nurse working in labor and delivery at a local hospital. D.H. comes to the unit having contractions and feeling somewhat uncomfortable. You take her to the intake room to provide privacy, have her change into a gown, and ask her three initial questions to determine your next course of action, that is, whether to do a vaginal exam or to continue asking her more questions.

What three initial questions will you ask, and why?

D.H. has contractions 2 to 3 minutes apart and lasting 45 seconds. It is her third pregnancy

(gravida 3, para 2002). Her bag of waters is intact at this time. She states that her due date is 2

days away. You determine that it is appropriate to ask for further information before a vaginal

exam is done. What information do you need?

What assessment should you make to gain further information from D.H.?

Upon examination, D.H. is 80% effaced and 4 cm dilated. The fetal heart rate (FHR) is

150 beats/min and regular. She is admitted to a labor and delivery room on the unit. What

nursing measures should be done at this time?

List the stages of labor. D.H. is in what stage of labor?

D.H. states that she is feeling discomfort and asks you whether there is alternative therapy

available before taking medication. List at least four alternative methods to assist D.H. with

controlling her discomfort.

As you assess both the mother and the fetus during the active stage of labor, you will look

for abnormalities. Which of these are potential abnormalities during labor? (Select all that

apply.)

Unusual bleeding

Brown or greenish amniotic fluid

Contractions that last 40 to 70 seconds

Sudden, severe pain

Increased maternal fatigue

11 Maternal/ObstetricCASE STUDY PROGRESS

Although D.H. continues to use alternative therapies for discomfort, she asks for pain medication and receives a dose of meperidine (Demerol). Three hours later, D.H. is lying on her back, and during contractions you notice a few late decelerations of the FHR. You stay with D.H. to monitor her and her fetus and immediately call for someone to notify the PCP.

Put these actions in order of priority accompanied with an explanation to why you chose that particular order.

Discontinue the oxytocin infusion.

Turn D.H. onto her left side and elevate her legs.

Increase the rate of the maintenance IV fluids.

Administer oxygen at 8-10 L/min by facemask.

Decelerations occur in an early, variable, or late pattern. What is the significance of these

patterns? State what the nurse should do for each type.

As you monitor D.H., you observe for prolapse of the umbilical cord. Describe what this is

and what can happen to the fetus if this occurs.

What would be done if you noted that D.H. had a prolapsed cord?

The decelerations stop, and the remainder of the labor is uneventful; D.H. has an episiotomy to allow

more room for the infant to emerge and delivers a male infant.

What is involved in the immediate care of the newborn?

As you assess the newborn, you observe for CNS depressant effects that might result because the mother received an opioid during labor. Opioid antagonists such as naloxone (Narcan) can promptly reverse the CNS depressant effects in the newborn, but when is naloxone contraindicated for an infant?

D.H. has her episiotomy repaired and the placenta delivered. What are the signs that the

placenta has released from the uterine wall?

What assessments are important for D.H. following delivery?

CASE STUDY OUTCOME

FINAL OUTCOME: D.H. and her newborn baby boy are taken to the maternity unit where she begins to breastfeed him

yellowbear651

NUTR 2050 Chapter 7: Chapter 7.docx

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