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Name:Noor Abu sedaa
ID number:-200810611
Subject:Promoting nutritional health during pregnancy
Dr
Aida abd el-razek
Outline:* Relationship of maternal nutrition
to infant health .
*Weight gain during pregnancy.
* Diet pregnancy .
Outline;-
Outline
Objectives ;The Student Able to :
*Identify the effect of the maternal
nutrition to the fetus health .
*Identify the total weight gain during
pregnancy for each body organ .
* Calculating the total body mass
index for pregnant women .
* Identify the essential nutrients
need during pregnancy .
* Management the problems that
is may a cure in pregnancy .
Relationship of maternal
nutrition to infant health
* During pregnancy awomen must
eat adequately to;1- supply enough nutrients to the
fetus so it can grow.
2-support her own nutrition .
Cont:-
• Adequate protein intake is vital
because so much needed by a fetus
and also help to prevent complication
of pregnancy such as pregnancy
induced hypertension or preterm
birth .
• Overuse of vitamins or deficiency
may contribute to birth anomalies .
weight gain during
pregnancy
* Weight gain of 11.2 to 15.9 kg is currently
recommended as an average weight gain in
pregnancy .
* Weight gain in the first trimester is 1-2 kg
* Weight gain in the second trimester is 67kg
* Weight gain in the third trimester is 3-4
kg
Cont…
* Most pregnancies estimation for
adequate weight gain this is done
by computing body mass index .
• Calculating body mass index
(BMI)
Body mass index = [weight
/height (m2)]
Normal pregnancy BMI
Underweight
under 18.5
Normal weight
18.5 -24.9
Overweight
25.0-29.9
Obese
above 30
•
•
•
•
•
•
•
•
Breast ( o.6 -1.3 ) kg
Fetus ( 3.4 ) kg
Uterus ( 1.1 ) kg
Body fluid ( 1.8 ) kg
Placenta ( 0.6 ) kg
Amniotic fluid ( 0.9 ) kg
Body fat ( 3.8 ) kg
Blood volume ( 1.8 ) kg
Healthy diet includes :. Proteins
. Carbohydrates
. Fats
. Vitamins
. Minerals
Proteins :• During pregnancy the need for
protein increase to 60 gm daily .
• Sources of protein :Meat , poultry , fish , yogurt ,
eggs , and milk it is considered
extra protein because these
forms contains all nine essential
amino acids or is complete
protein
Cont…
• the protein in non-animal sources
doesn’t contain all essential amino
acids (incomplete protein ) its
possible to provide all amino acids by
combining non-animals protein when
cooked together .
• Examples : beans and rice , beans
and wheat .
Carbohydrates :Sources of carbohydrates;• Carbohydrates come from
starches and sugars .
• Starch are present in potatoes,
pasta, rice ,and cereals .
Inadequate intake of
carbohydrate may leading to
protein breakdown for energy
,depriving a fetus off essential
protein , and resulting in
ketoacidosis a possible cause of
fetal and neurologic disorders
Fats :• The only essential fatty acid necessary for
new cell growth is linoleic acid .
• Sources of linoleic acid ;
Vegetables oils ( ex; safflower, corn, olive,
peanut, and cottonseed ) that have a low
cholesterol content therefore protection
from hypercholesterolemia, and coronary
heart disease .
Vitamin A :A fat soluble vitamin is important for
1- maintenance of visual function .
2- promotes cellular growth .
3- differentiation in other tissues .
* Sources :Green leafy vegetables and yellow
orange vegetables .
*DRI ( 800 mcg )
Vitamin D :A fat soluble vitamin is found in
milk .
Functions :Healthy bones and healthy teeth
Aids absorption of calcium .
Vitamin C :-
Water soluble vitamin
Functions :Healthy gum, teeth , and bones
Assistance with iron absorption
Cont…
Sources
;-
Fruits and vegetables
DRI for pregnancy is 10 mg
folic Acid
Is a water soluble B-complex vitamin
Functions :-
* Important for DNA synthesis .
* Cell replication .
Cont…
* Necessary for red blood cell
formation
* Important in preventing neural
tube defect .
Sources:Grains, beans, green leafy vegetables,
dark yellow fruits, vegetables, and
nuts .
The pregnant women should be taken in
the first trimester to protection the
fetus from neural tube defect.
The women can be taken before
pregnancy because it is protection
from spina bifida
Cont…..
note Deficiency in pregnancy has been
linked with maternal megaloblastic
anemia and fetal neural tube defect
such as spina bifida
* DRI (400 microgram) during
pregnancy .
Minerals and elements
Calcium :Is a major component of bone strong,
teeth, muscle contraction, and nerve
function .
Sources :Diary product, leafy green, milk,
cheese, yogurt, and sardines.
The pregnant need to eat food high in
calcium and vitamin D ( necessary for
calcium absorption from GIT tract and
to enter bones ) .
The recommended amount of calcium
during pregnancy is (1,200 – 1,500) mg .
Phosphorus :* for bone formation.
* found in the milk .
* Most food high in protein are also high
in phosphorus so by eating high-protein
foods, women receive enough
phosphorus .
* Pregnant women need 1200 mg
Zinc :* Is necessary for the synthesis of
DNA and RNA
* Zinc deficiency may be associated
with preterm birth .
* Sources :Meat, liver, eggs, and seafood .
* The DRI for zinc during pregnancy is
15 mg .
Iron
*fetus :1- Is necessary to production of
hemoglobin .
2-store it in the liver to last
through the first 3 months of life
* Pregnant women :1- increased red cell volume for herself
2-protect against iron lost in blood at
delivery .
Cont…..
* Sources :Spinach, liver, organ meats, eggs,
wholes grains , dried fruits .
* The DRI for iron pregnant women is
30 mg
Iodine :Is essential for the formation of the
thyroxin and therefore, functioning
of the thyroid gland .
* If iodine deficiency occurs it can
cause thyroid enlargement (goiter) in
a women and in extreme instances it
may cause hypothyroidism in a fetus
* Seafood is the best source.
* DRI for iodine is 175 mg daily .
Nutrient deficiency associated
with adverse pregnancy outcomes
Folic acid
Neural tube defect
Iron
Anemia , hemorrhage
Vitamin D
Neonatal
hypocalcaemia
Vitamin k
Haemorrhage
Calcium
Hypertension, preeclampsia .
Fluids and fibers:* Fluids :-
extra amounts of water are needed
during pregnancy to promote
kidney function because a women
must excrete waste product for
two .
* DRI of water is six glasses .
Fibers ;*The advantages of fibers;1- prevent constipation .
2- lowering cholesterol level .
3- may remove carcinogenic contaminate
from the intestine .
* Constipation can occur during pregnancy
from slowed peristalsis due to the
pressure of the uterus on the intestine .
Cont…..
Sources :Fresh fruits and vegetables , especially
green, leafy vegetables
Foods avoid in pregnancy
1- foods with caffeine :It is stimulant of the central nervous
system which capable of increasing
heart rate, urine production, and
secretion the acid in the stomach .
• Sources :Chocolate,coffe,and tea.
2- Artificial sweeteners :* The used of saccharine is not
recommended during pregnancy because
it is eliminated slowly from the fetal
blood stream .
* The pregnant need carbohydrates
furnished by sugar rather than artificial
substances .
Stop
3- weight loss diet ;-
* Reducing diets and calorie
restrictions are contraindicated
during pregnancy because they may
lead to fetal ketoacidosis and poor
growth .
Stop
Managing problems Affecting
Nutritional health
• Nausea and vomiting :Occur in the first trimester may be due to ;
1- sensitivity to the high level of chorionic
gonadotropin hormone produced by the
trophoblast cells .
2- high estrogen or progesteron levels .
3- lack of pyridoxine
(vitamin B6 )
Cont…..
4- lowered maternal blood sugar levels
caused by the needs of the developing
embryo .
5- diminished gastric motility
Management :1-eat small but frequent meals rather
than large infrequent ones .
2-avoid sudden movements and fatigue
because these may increase or cause
nausea
3-try a walk outside in the fresh air
or take deep breaths through an
open window if nausea is present .
4- avoid greasy or highly seasoned
food .
5 delay breakfast until nausea
passes ( dinner if it is evening
nausea ) .
It is the term used when a mother
craves certain food or non food
substances .
• Craving are actually more likely the
result of a physiological need for more
carbohydrate or particular vitamin and
minerals .
Management :* The nurse should be seek medical
advice if these substances harmful
to the fetus .
Pyrosis ( heart burn )
Is a burning sensation along the esophagus
caused by regurgitation of gastric
content into the lower esophagus .
* Heart burn probably caused by
decreased gastric motility , which
slow gastric empting , and pressure
of the expanding uterus against the
stomach .
• Management:1- eat small meals frequently .
2- sleep with two pillows can sometimes
help .
3- don’t lie down immediately after
eating .
Constipation
Causes :1-Slow gastric empting and intestinal
motility due to increase reabsorption
of water and electrolytes in large
intestine .
2-Associated with the taking of oral iron.
Managements :-
1-Eating fruit and vegetable will
reduce constipation .
2- Exercise and drinking enough fluid
( eight glasses of water per day )
3- don’t use laxatives while you are
pregnant unless your doctor advise
to use it .
Reference
Maternal And Child Health Nursing