Chapter 13
The Nursing Role in Promoting Nutritional Health During Pregnancy
Maternal Nutrition and Fetal Health #1
❖ Weight gain during pregnancy
o Average woman should gain 25 to 35 lb.
o Weight gain
▪ During the first trimester, occurs at approximately 0.8 kg (1.5 lb) per month
▪ During the last two trimesters, 0.4 kg (1 lb) per week
❖ Components of healthy nutrition
o Calorie needs
o Protein needs
o Fat needs
o Vitamin needs
o Mineral needs
❖ Calcium and phosphorus
❖ Iodine
❖ Iron
❖ Fluoride
❖ Sodium
❖ Zinc
o Fluid needs
o Fiber needs
o Foods to avoid or limit
❖ Alcohol
❖ Caffeine
❖ Artificial sweeteners
❖ Weight-loss diets
2020 National Health Goals Related to Nutrition in Pregnancy
❖ Reduce iron deficiency among pregnant women from a baseline of 16.1% to 14.5%.
❖ Increase the proportion of women of childbearing potential with intake of at least 400 µg of folic
acid from fortified foods or dietary supplements from a baseline of 23.8% to a target of 26.2%.
❖ Increase the proportion of women who achieve a recommended weight gain during their
pregnancies.
Nursing Process: Nutritional Health During Pregnancy
❖ Assessment
❖ Nursing diagnosis
❖ Outcome identification and planning
❖ Implementation
❖ Outcome evaluation
Assessing Nutritional Health During Pregnancy #1
❖ Lifestyle considerations
o Family
o Financial
o Cultural
Nursing Diagnoses: Nutritional Health During Pregnancy #1
❖ Imbalanced nutrition, less than body requirements, related to increased physiologic needs
❖ Imbalanced nutrition, less than body requirements, related to nausea every morning
❖ Health-seeking behaviors related to determining best food choices in pregnancy
❖ Imbalanced nutrition, more than body requirements, related to chronic poor eating habits
❖ Deficient knowledge related to need for increased intake of nutrients and calories during
pregnancy
Outcomes: Nutritional Health During Pregnancy
❖ Patient demonstrates weekly menus that include three main meals and two snacks per day.
❖ By next prenatal visit, patient demonstrates knowledge of meat and nonmeat sources of protein
by providing menus of meals eaten in the last week that include fish, eggs, beans, or peanut
butter.
❖ Patient verbalizes correct information about calcium needs during pregnancy.
Nursing Care to Promote Nutritional Health During Pregnancy #3
❖ Common problems affecting nutritional health
o Cravings of nonfood substances (pica)
▪ Referral to primary care provider for iron-deficiency anemia evaluation
o Diminished gastric mobility
▪ Dietary measures; regular bowel evacuation; stool softener or evacuation
suppository if needed
o Pyrosis
▪ Eat small meals frequently; sleep on left side with two pillows to elevate upper
torso; wait 2 hours after eating before laying down; avoid fatty and fried foods,
coffee, carbonated beverages, tomato products, citrus juice
o Hypercholesterolemia
▪ Exercise daily; eat oat cereal; broil, grill, or bake meat; use minimum salad oils;
substitute omega-3 products for butter; eat fish high in omega-3 oil
Nursing Care to Promote Nutritional Health During Pregnancy #6
❖ Woman with unique needs
o Adolescent
o Older than 40 years of age
o Stressful lifestyle
o Decreased nutritional stores
o Underweight
o Overweight
o Vegetarian
o Phenylketonuria
o Multiple pregnancy
o Smoker or uses drug or alcohol
o Health problems
o Culturally prepared foods
o Lactose intolerance
o Bariatric surgery
o Hyperemesis gravidarum
❖ Severe nausea and vomiting
❖ Unable to maintain usual nutrition
❖ Therapeutic management
