SAN PEDRO COLLEGE

BACHELOR OF SCIENCE IN NURSING

MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

❖ Source of nourishment :
PREGNANCY AND LACTATION
❖ There is a relationship between mothers diet and
the health of the baby at birth.
❖ If the mother is healthy, especially if the mother is
consuming a balanced diet or applying proper
nutrition before, during, and after pregnancy, then
mostly likely, the mother is to bear a healthy infant
than who did not.
● Uterine substances (UTMP)
➔ UTMP is a substance or uterine milk
➔ Another term of the UTMP is uterine milk
or womb milk
➔ Produced in glands in the endometrium
(the lining of the uterus) and endometrium
will secrete UTMP (Uterine Milk Protein)

GESTATION ➔ If the mother is healthy, most likely she will

produce a health and nutritious UTMP

➔ Two hormones that helps and facilitates

the production and secretion of UTMP:
➢ Progesterone
➢ Will stimulate the glands to
secrete UTMP

➢ Stimulates the lining of the uterus

called endometrium or
endometrium gland

➢ Estrogen
➢ Causes endometrium to thicken to
produce UTMP

➔ UTMP
➢ It's a white secretion containing
❖ Pregnancy is also known as gestation
protein and amino acid
❖ Gestation is the medical term of pregnancy
➢ This protein and amino acid nourishes
❖ Is the period from conception to birth the embryo during development or the
● The moment the mother will conceive, that is actual nutritional liquid that feeds the
already called gestation embryo (developing fetus)

● After giving birth is also gestation ❖ Adverse Influences are:

● Smoking drug abuse, and malnutrition
❖ That is 38 to 42 weeks or 9 months pregnancy ➔ These will result to:
➢ Failure to implant
❖ Divided into 3 trimesters
➢ Neural Tube Defect (NTD)
❖ Has 3 events or periods
2. ORGANOGENESIS
1. IMPLANTATION PERIOD ❖ Period of organ formation
❖ Event or period
❖ Occurs from 2 to 8 weeks after conception or next 6
❖ Fertilized ovum implants itself in the uterus and weeks
begins to develop
● Conceiving ❖ Critical period when organs are formed and most
vulnerable to adverse influences
❖ Occurs during the 1st 2 weeks of conception ● The mother shouldn't be smoking, take illegal
● 2 weeks after LMP (Last Menstrual Period) is drugs, too much alcoholic beverages
already conception consumption, and malnutrition

VIANNE PALMA I 1
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO
❖ Source of nourishment:
● Maternal tissue
➔ If the maternal tissue is unhealthy, most
likely the baby is not well fed or will
become malnourished after birth
➔ 8 to 12 weeks into pregnancy
➔ Endometrium secretes glucose
➢ Glucose is the storage form of
glycogen from the mother
➢ The storage form of the mom should
be enough and adequate is she wants
to be pregnant
➢ Pre-preparation before pregnancy
➔ This glycogen can be converted into
glucose as a source for the baby before
placenta takes over as a source of
nourishment
3. RAPID FETAL GROWTH
❖ The last 7 months
❖ Characterized primarily by growth in the number of
cells and size of the organs until it can support an
extra uterine environment.
❖ Source of nourishment:
● Placenta
❖ Simple diffusion
● Process of the transfer of the oxygen, carbon
dioxide, fatty acid, steroids, nucleotides,
electrolytes, and fat soluble vitamins from the
mother to the fetus
● From the mother, to the placenta, and to the
fetus
● Passive process in which nutrients move from
high concentration in the maternal blood to
lower concentration in the fetal capillaries until
equilibrium is reached
● O2, CO2, FA, Steroids, Nucleotides,
electrolytes, and Fat soluble vitamins
➔ These nutrients are transferred from the
mother to the placenta via simple diffusion
HABITS TO ESTABLISH IN PREPARATION FOR
A HEALTHY PREGNANCY
1. Achieve and maintain a healthy body weight.
2. Choose an adequate and balanced diet.
3. Be physically active.
4. Avoid harmful influences.
1. ACHIEVE AND MAINTAIN A HEALTHY BODY
WEIGHT.
❖ If a woman wants to be pregnant, she should be
within the desirable body weight before, during, and
after pregnancy
❖ UNDERWEIGHT PREGNANT
● If the pregnant mother is underweight, she is
at a high risk of giving birth to a low birth
weight (LBW) infant.
● Low Birth Weight (LBW)
➔ Infants have impaired growth and
development
➔ Prone to infection and disease
➔ Will have lower adult IQ
● One of the consequence of a mother giving
birth to a premature baby is Patent Ductus
Arteriosus (PBA)
➔ Happens 10% of the babies born between
30 and 37 weeks of pregnancy
➔ Patent = open
➔ After birth, its normal for the ductus
arteriosus of the baby to be open and it
will just gradually close after 1 to 3 days,
but if the baby is premature, it will not
close
➔ If the PBA will not close on its own, it will
cause lung problems
➔ It will develop from long exposure to extra
blood flow, so this PBA will let oxygen
reach blood or blood high in oxygen and
from the aorta mixed with blood low in
oxygen in the pulmonary artery, which
results in heart chanting.
➔ Causes of heart chanting:
➢ There is an extra blood flow of both
rich oxygenated blood and poor
oxygenated blood from the aorta to the
pulmonary artery
VIANNE PALMA I 2
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

❖ OVERWEIGHT OR OBESE PREGNANT ❖ FACTORS THAT CONTRIBUTE TO THE WEIGHT

● Obesity is a chronic type of malnutrition GAIN IN PREGNANCY
because it can be passed unto a child during
pregnancy

● Birth defects
➔ Heart defects and neural tube defects
(NTDs)

● Problems with diagnostic tests

➔ Too much body fat leads to inaccurate
ultrasound results.

➔ Abdominal ultrasound is not allowed and

the doctor might recommend vginal
ultrasound to get an accurate result
● Macrosomia
➔ In this condition, the fetus is larger than
normal. Baby have a greater chance of
being obese later in life.
● Preterm birth
➔ Obese pregnant may developed
preeclampsia, may lead to a medically
indicated preterm birth.
2. CHOOSE AN ADEQUATE AND BALANCE DIET
❖ Malnutrition reduces fertility and impairs the early
development of an infant.
❖ Placental development, implantation, and early
critical periods of embryonic and fetal development
depend on maternal nutrition before and during
pregnancy.
❖ Dietary Management:
● Pinggang pinoy
➔ Green for pregnant women

➔ Especially if the mother reached 220 to ● The basic food groups

110 bp and the mother already ➔ Energy giving foods
experiencing nausea and vomiting (one of ➔ Body building foods
the signs of preeclampsia), the doctor ➔ Body regulating foods
might recommend termination of
pregnancy

● Stillbirth
➔ The higher the woman’s BMI, the greater
the risk of stillbirth.

❖ RECOMMENDED WEIGHT GAINS BASED ON

PREGNANCY WEIGHT

Pre-pregnancy Recommended Weight

Weight Gain

Underweight 28 to 40 lb
(BMI <18.5) (12.5 to 18.0 kg)

Healthy weight 25 to 35 lb
(BMI 18.5 to 24.9) (11.5 to 16.0 kg)

Overweight 15 to 25 lb
(BMI 25.0 to 29.9) (7.0 to 11.5 kg)

Obese 15 lb minimum
(BMI ≥30) (6.8 kg minimum)

VIANNE PALMA I 3
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO
● What would be the benefit of dietary fiber for
pregnant mothers? Why should we
recommend complex carbohydrates such as
food high in fiber like brown rice, corn, whole
wheat, bread, and oatmeal?
➔ Oatmeal is for prevention of heart
diseases, diabetes, and other health
problems because the mother is prone to
pregnancy hypertension and diabetes
during pregnancy.
● Go (Energy giving foods)
➔ 33% of the other half of my plate
● Grow (Body building foods)
➔ For body building foods, it is
recommended for pregnant mothers to eat
white meats (fish, shellfish, lean meat,
poultry) because it is less in atherogenic
materials rather than red meats. Although
red meats are high in iron and protein,
they have adverse effects. The mother can
have red meat but should be taken
moderately or in accordance to the PDRI
(Philippine Dietary Reference Intake)
➔ Natural fatty fish
➢ Rich in omega 3
➔ Bones of small fish are rich in calcium
➔ Give substitutes like beans and nuts
➔ The mother should also consume milk and
milk products for calcium and iron content
for the development of the bones and
teeth of the baby.
● Glow (Body regulating foods)
➔ The mother should take 33% of half of the
plate for body regulating foods
● Water
➔ The mother should be kept hydrated
➔ Give more water than flavored drinks
● Why do we need to choose an adequate
and balanced diet?
1. Resting Metabolic Rate increases
during pregnancy because of increased
body mass due to the growing fetus
inside.
➢ There are also pregnancy associated
physiological changes.
➢ Thyroid gland works double for the
mother and the child.
➢ Examples of pregnancy associated
physiological changes:
➢ Cardiac output
➢ The growing fetus
➢ Maternal physiological during
pregnancy include: (decreased BMR
because of these reasons)
➢ Increased maternal fat
➢ Total body water
➢ 50% increase in fluid for the
sake of the baby
➢ Decreased plasma protein
concentration (especially
albumin)
➢ There should be a water in the
plasma and albumin
➢ Albumin helps keeping the
water in the plasma or blood
➢ Increased maternal volume
➢ Increased cardiac output
➢ Increased blood flow to the
kidneys and uteroplacental unit
➢ Decreased blood pressure
➢ Because the body secretes
hormones, especially
progesterone in particular, it
helps relax the walls of the
blood vessels and increase
the blood flow to the mother
and her baby.
➢ Relaxed diameter of the blood
vessels will also decrease the
blood pressure of the blood.
NUTRITIONAL REQUIREMENT
❖ ENERGY
● Normal TER + 340 kcal on the start of 2nd
semester
➔ The baby is solely relying on the uterine
milk protein and the glycogen source of
the mother or glucose supply.
● Normal TER + 450 KCAL on the 3rd trimester
VIANNE PALMA I 4
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO
● Choose nutrient–dense foods
● RATIONALE:
➔ To supply the increased fuel, demanded
by the enlarged metabolic workload.
➢ Thyroid gland is working hard during
pregnancy because there are two
BMR, one for the mother and the other
one is for the baby.
❖ CARBOHYDRATES
● 60% of TER/ day
● RATIONALE:
1. Necessary to fuel the fetal brain.
➢ Glucose is the main source of energy
for the brain
2. Fiber in CHO rich foods such as Whole
Grain, Vegetables, and Fruits will help
alleviate constipation.
3. To spare CHON for the added
tissue-building requirement.
➢ There is much metabolic reaction or
synthesis during pregnancy for the
fetus.
➢ Positive nitrogen balance during
pregnancy. Meaning, more synthesis
than degradation.
❖ PROTEINS
● + 25g to normal CHON requirement/day
● RATIONALE:
1. For baby’s rapid growth
2. For the development of the placenta
3. Due to the increase in maternal blood
volume
4. Needed in the synthesis of Hgb and
plasma CHON.
5. For the formation of amniotic fluid
6. For tissue storage reserve of the mother
especially during pregnancy and
post-partum
VITAMINS SUPPLEMENTATION
1. VITAMIN C
● AI or RDA
➔ < 18 y/o - 80mg/day
➔ 19-50 y/o - 85mg/day
● RATIONALE:
1. To prevent preeclampsia
➢ Especially if the mother is suffering
from gestational hypertension or PIH
(Pregnancy Induced Hypertension)
2. THIAMIN (B1)
● AI or RDA (according to age)
➔ < 18 y/o - 1.4mg/day
➔ 19-50 y/o - 1.4mg/day
● RATIONALE:
1. For loss of appetite.
➢ Because of nausea and vomiting
2. For increase in metabolic workload.
➢ Thyroid gland is working for two
3. Prevention of beri-beri.
➢ Especially edema during the latter
stage of pregnancy
4. To prevent leg cramps.
➢ Sudden contraction in the
gastrocnemius muscle
● Richest food source:
➔ Enriched or fortified whole grains and
products.
3. PYRIDOXINE
● AI or RDA -1.9 mg/day
● RATIONALE:
1. To prevent nausea and vomiting.
2. To prevent convulsion.
3. Facilitated by niacin
➢ The production of red blood cell
● Richest food source:
➔ Meats, fish, poultry, liver
➔ Potatoes, legumes, non-citrus fruits, soy
products
4. FOLIC ACID
● AI or RDA - 600 mcg/day
VIANNE PALMA I 5
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

● Folic acid is important for erythropoiesis ➢ Prone and sensitive to

(production of red blood cell and development infection
of new cells) and to prevent neural tube defect

● RATIONALE:
1. For blood volume increase.

2. Development of new cells

3. To prevent Neural Tube Defect (NTD)

➢ FACTORS AFFECTING NTD
1. Inadequate folate

2. NTD on previous pregnancy

3. Gestational Diabetes Mellitus

(GDM) ● Highest Food sources of folate:
Natural Folate Sources
4. Use of anti-seizure medications 1. Liver (3 ounces ) = 221mcg
➢ Should be given moderately
5. Maternal obesity
2. Asparagus (1/2 cup) = 131mcg
6. Exposure to high temperature
(fever, hot tub use) 3. Spinach (1 cup raw) = 131mcg

7. Race/Ethnicity – common among 4. Avocado (1/2 cup) = 45mcg

Hispanic people ➢ Monounsaturated fatty acid

8. Low economic socio status ➢ Should be given according to

requirement or adequate intake only
➢ 2 KINDS OF NTD because it has fat content
1. Anencephaly
➢ An uncommon and always 5. Orange juice (1 cup) = 74 mcg
fatal type of NTD
Fortified Folate sources
➢ Characterized by the absence 1. Pasta cooked (1 cup) 110mcg
of a brain.
2. Rice cooked (1 cup) 134mcg
➢ Brain is not developed
3. White bread (1 slice) 28mcg

5. COBALAMIN
● Works with folate and is more on the
production and maturation of red blood cells

● AI or RDA = 2.6 mcg/day

● RATIONALE:
➔ For maturation of RBC

2. Spina Bifida ● Richest Food Sources:

➢ One of the most common ➔ Meat, fish, poultry, shellfish, milk , cheese
types of NTD, characterized and eggs
by the incomplete closure of
6. VITAMIN A or RETINOL
the spinal cord and its bony
● AI or RDA
encasement.
➔ 18 Y.O and below = 750 mcg/day

VIANNE PALMA I 6
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

➔ 19 to 50 Y.O = 770 mcg/day ➢ Syndrome characterized by abnormal

muscle twitching, cramps, sharp
● FUNCTIONS: spasms of joints in wrists and ankles.
1. Important for the placenta functions
➔ Rickettes (preschool and school age)
2. For the integrity of the epithelial cells
➢ To prevent serotonia it provides mucus ➔ Osteoporosis (adult)
around our epithelial cells that
prevents it from drying and infection ● AI or RDA
➔ 5 mcg / day
3. Skeletal formation
● Food sources:
4. Tooth formation and normal bone growth 1. Fortified milk

● Excessive intake of Vitamin A can also result 2. Fortified margarine

to physical malformation of the fetus
3. Fortified butter
● Food sources:
Fruits per 100g 4. Eggs
1. Milon = 1285 mcg
5. Liver
2. Tesa = 1235 mcg
6. Salmon, sardines
3. Mango ripe = 1165 mcg ➢ The more we eat the biomes of small
fishes, the Vitamin D we get
Liver per 100mg = 5,525 mcg
MINERALS
Vegetables per 100g 1. CALCIUM
1. Malunggay = 7,945 mcg ● AI/RDA
➔ 1,300mg /day (14 -18yr)
2. Saluyot = 7,320 mcg
➔ 1,000mg /day (19 – 50yr)
3. Upo = 6439 mcg
● For fetal bone development
4. Tanglad = 4,205 mcg
● For dentition
5. Ampalaya leaves = 4,105
● FOOD SOURCES:
6. Camote tops = 3,195 mcg 1. 3 cups of milk = 300mg
7. Alugbati = 2,735 mcg 2. Sardines with bones 3oz = 324 mg
8. Lettuce = 2,350 mcg 3. Tofu ½ cup = 275mg
9. Onion leaves = 2,065 mcg 4. Cheddar cheese 1 ½ oz = 306mg
7. VITAMIN D 5. Broccoli 1 ½ cup = 93 mg
● Maintain normal calcium metabolism
2. PHOSPHORUS
● Cholesterol is important for synthesis and ● AI/RDA
activation of Vitamin D ➔ 1,250mg/day (14-18yr)
● Promotes normal bones and teeth formation. ➔ 700mg/day ( 19-50yr )
● Prevent Tetany during infancy ● Involved in fetal skeleton building with Ca
➔ TETANY (baby)

VIANNE PALMA I 7
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO
● FOOD SOURCES:
1. All animal tissues
3. MAGNESIUM
● AI/RDA
➔ 400mg/day (14-18yr)
➔ 350mg/day (19-30yr)
➔ 360mg /day ( 31-50yr)
● Involved in bone mineralization
● Normal muscle contraction
● Transmission of nerve impulses
● Maintenance of teeth
● FOOD SOURCES:
1. Spinach cooked ½ cup = 78 mg
2. Black beans ½ cup = 60mg of Mg
3. Soymilk 1 cup = 46 mg of Mg
4. Yogurt 1 cup = 43mg of Mg
5. Oysters 3 oz = 81 mg of Mg
6. Bran cereal 1cup = 60mg of Mg
4. IRON
● AI/RDA = 27mg/day
● Conservation of iron during pregnancy
● Maintenance of erythropoiesis
● To prevent anemia
● To have sufficient supply of Hgb
● FOOD SOURCES
1. Clams ( steamed ) 3 oz = 23.8mg
2. Lean beef steak 3 oz = 2.6 mg
3. Black beans ½ c = 1.8mg
4. Enriched cereal 1cup = 8.1 mg
5. Spinach cooked ½ cup = 3.2 mg
6. Beef liver 3 oz = 5.24mg
5. IODINE
● AI/RDA = 220 mcg (18 – 50yr)
● To increase milk flow
● To compensate for the increase in BMR
● To prevent cretinism
● FOOD SOURCES:
1. Iodized salt and seaweeds (seafoods)
6. ZINC
● AI/RDA
➔ 12mg/day (18yrs and below)
➔ 11 mg/day (19-50 yrs)
● For CHON synthesis
● For DNA and RNA synthesis
● To prevent diarrhea
● FOOD SOURCES:
1. Oysters –steamed 3 oz = 72 mg
2. Lean beef steak 3 oz = 4.9 mg
3. Yogurt 1 c = 2.2 mg
4. Shrimp 3 oz = 1.5 mg
5. Enriched cereal 1 c = 3.8mg
6. Pork Chop 3oz = 2mg
7. SODIUM
● AI/RDA
➔ 1,500 mg/day (18yr and below)
➔ 1, 500mg/day (19 to 50 yr old)
● Keep minimal to prevent edema and PIH
➔ Pregnancy induced hypertension or
gestational hypertension
● FOOD SOURCES:
1. Table salt, soy sauce, processed foods
3. BE PHYSICALLY ACTIVE
❖ A woman who wants to be physically active when
she is pregnant, needs to become physically active
beforehand.
❖ Staying active during the course of a normal,
healthy pregnancy will:
VIANNE PALMA I 8
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

1. Improves the fitness of the mother-to-be ● Don’t scuba dive.

2. Facilitates labor ❖ Suitable activities during pregnancy include:

● Brisk walking
3. Helps to prevent or manage gestational
diabetes and gestational hypertension ● Swimming
➔ Muscle provides higher endurance to the
mother and a better supply of oxygen ● Indoor stationary cycling
during pregnancy and labor
● Prenatal yoga
4. Reduces psychological stress.
● Low impact aerobics under the guidance of a
❖ Guidelines for Physical Activity during certified aerobics instructor
Pregnancy
● Do exercise regularly (most, if not all, days of ● Special exercises to prepare for labor and
the week). delivery

● Do warm up with 5 to 10 minutes of light

activity.

● Do 30 minutes or more of moderate physical

activity.

● Do cool down with 5 to 10 minutes of slow

activity and gentle stretching.

● Do drink water before, after, and during

exercise.

● Do eat enough to support the additional needs

4. AVOID HARMFUL INFLUENCES
of pregnancy plus exercise.
❖ both maternal and paternal ingestion of harmful
● Do rest adequately. substances (cigarettes, alcohol, drugs or
environmental contaminants) can alter genes or
● Don’t exercise vigorously after long periods of their expression.
inactivity.
❖ It can also interfere fertility and will cause
● Don’t exercise in hot, humid weather. abnormalities

● Don’t exercise when sick with fever. ❖ PRACTICES TO AVOID IN PREGNANCY:

1. CIGARETTE SMOKING
● Don’t exercise while lying on your back after ➔ Nicotine and cyanide
the first trimester of pregnancy or stand ➢ Toxic to the fetus
motionless for prolonged periods.
➔ May give the mother back pains and ➔ Adverse effects:
obstruct flow from the large veins in the 1. Damage chromosomes
thigh, go back to the artery and may lead ➢ Will lead to developmental
to leaking of water from the blood to the defects, genetic disorders and
feet, resulting in edema. cancer.

● Don’t exercise if you experience any pain or
discomfort.
● Don’t participate in activities that may harm the
abdomen or involve jerky, bouncy movements.
2. Limit blood supply that will also limit
delivery of O2, nutrients and removal
of waste
3. Retard physical development

VIANNE PALMA I 9
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

4. Cause behavioral or intellectual ➢ Caused by: Bacterium Listeria

problems Monocytes

5. Low Birth Weight (LBW) ➢ If severe infection, may result to

severe brain infection or death in the
2. MEDICAL DRUGS AND HERBAL fetus or newborn
SUPPLEMENTS ASPIRIN AND IBUPROFEN
➔ Aspirin and Ibuprofen should not be used ➢ Spica
during the last 3 months unless prescribed ➢ Craving for something that is not
by the doctor because it may result to edible
excessive bleeding during delivery
6. VITAMINS AND MINERALS MEGADOSES
3. DRUG ABUSE ➔ Toxicity of vitamins
➔ Amphetamines
➢ Suspected nervous system damaged ➔ Ex: Toxicity of Vitamin E that will result to
and may result to behavioral teratogenic or malformation of the physical
abnormalities appearance/features of the baby

➔ Barbiturates 7. DIETARY
➢ May result to withdrawal symptoms in
the baby like high-pitched cry,
irritability, shaking, and jittering or act
nervously
➢ Neonatal Abstinence Syndrome
➔ Cocaine
➢ Uncontrolled jerking motion paralysis
➔ Low CHO or FATS can cause Ketosis
➢ If there is not enough supply of
carbohydrates for the source of
energy, fats and proteins can be
converted into ketones and
triglycerides to supply energy and will
result in ketosis.
➢ Too much ketone bodies in the blood.

➢ Permanent mental and physical 8. SUGAR SUBSTITUTE

damage to the baby ➔ Allowed as long as with FDA guidelines

➔ Marijuana ➔ Aspartame not recommended with

➢ Short term irritability at birth Phenylketonuria
➢ Because aspartame can be converted
➔ Opiates to phenylalanine in the body or
➢ Also known as heroin metabolized into phenylalanine.

➢ Drug withdrawal in the newborn ➢ End product of the metabolism of

aspartame is also phenylalanine.
➢ Permanent learning disabilities
➢ Attention Deficit 9. CAFFEINE
➔ Coffee and cola beverages may also result
➢ Hyperactive disorder to fetal death
4. ENVIRONMENTAL CONTAMINANTS 10. ALCOHOL
➔ Lead ➔ Fetus irreversible brain damage
➢ Damage on developing fetal nervous
system ➔ Growth retardation
➢ Stunting
➔ Mercury
➢ Can harm the developing brain system ➔ Mental retardation
of the baby
➔ Facial abnormalities
5. FOODBORNE ILLNESS
➔ Listeriosis ➔ Vision abnormalities

VIANNE PALMA I 10
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

DIETARY MANAGEMENT FOR COMMON ➢ Should be taken on a minimal

amount
MATERNAL DISCOMFORTS
➢ Disadvantages:
1. NAUSEA AND VOMITING ➢ If the mother is diabetic, it may
❖ Morning sickness aggravate the situation of
diabetes
❖ Most popular theory is that morning sickness is the
body's reaction to the pregnancy hormone, human ➢ Adverse effect:
chorionic gonadotropin (hCG) and progesterone ➢ Can trigger the spark up of
and estrogen glucose
● Human chorionic gonadotropin (hCG) is also
known as maternal recognition hormone 2. CHEMICALLY BLAND DIET
➢ Do not give food that is rich in
● During the early stage of pregnancy, the level chemical and substances
of these pregnancy hormones, hCG,
progesterone, and estrogen will rise quickly ➢ Avoid excessive spices and no
and may trigger the part of the brain that offensive odors
controls nausea and vomiting
➢ Cold or frozen drinks can be better
● Progesterone tolerated in morning sickness.
➔ Decreases smooth muscle contractility
➢ Do not drink juice, water, milk, coffee
➔ Decreased smooth muscle contractility will or tea when nauseated.
lead to the alteration of gastric emptying ➢ Will add to the bloating feeling of
the mother
➔ Delayed gastric emptying will lead to
increase nausea and vomiting because ● MANAGEMENT
the hydrochloric acid may tend to reflux 1. On waking, get up slowly

● Estrogen 2. Eat small frequent meals whenever

➔ Will slow gastric transit time and hunger strike
emptying bio nitric oxide ventilation
mechanism 3. Room should be in proper ventilation

● Lakihan ang space sa gastric muscle that will
lead to muscle relaxation in the gastro which
may subsequently contribute to the
phenomenon of morning sickness
❖ DIETARY MANAGEMENT
● DIET
1. HICHO (High Carbohydrates), LOW FAT
DIET
➢ Eat dry toast or crackers, jellies,
candies, and gums.
➢ Simple carbohydrates and can be
digested easily and vacate from
the stomach to the small intestine
and to the blood for absorption,
delivery and utilization, and will
not contribute to the slow
emptying of the gastro
4. Fluid between meals.
2. HEARTBURN
❖ Acid reflux
❖ Acidic stomach, causing burning sensation
❖ A pain felt in the chest by a burning sensation in the
esophagus which is located close to where the
heart is.
❖ The growing fetus weakens the LES (lower
esophageal sphincter) which is the main barrier of
gastric reflux from the stomach to esophagus.
● Hiatus ring
❖ DIET
1. Chemically bland diet
➔ Avoid spicy and greasy foods

VIANNE PALMA I 11
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

➔ Foods that may help reduce the symptoms 4. EDEMA

are: ❖ Caused by the pressure of the enlarging uterus on
➢ Vegetables, ginger, oatmeal, the veins that return fluid from the legs.
non-citrus fruits, lean meats, seafoods,
egg whites, healthy fats ❖ Swelling on the feet, ankles, and hands

❖ MANAGEMENT ❖ Reasons of edema during pregnancy:

1. Relax and eat slowly
2. Eat small frequent meals
3. Drink liquid between meals.
4. Sit up while eating.
5. Wait 1 hour after eating before lying down.
➔ May lead to acid reflux and weakens the
LES
6. Wait 2 hours after eating before exercising.
➔ Para fully digested and metabolized and
pagkain ni mother
3. CONSTIPATION
❖ Due to the pressure exerted by the developing fetus
on the digestive tract.
❖ Due to the increase of hormone progesterone
during pregnancy
❖ An increase in the progesterone hormone during
pregnancy cause the relaxation of the body’s
muscle and includes the muscle of the colon
❖ Slower moving in the intestine = slower digestion
● Leads to constipation
1. During pregnancy, the body of the mother
produces 50% more blood and bodily fluids
2. Edema will occur when the enlarged uterus
intermittently or irregularly compresses the
inferior vena cava during recumbency or when
the mother is resting
➔ Flow obstruction of blood that leak of
fluids from the blood to the leg causing
edema
3. The nature of the work of the mother needs
her to sit for several hours may lead to the
obstruction of the blood flow from both
femoral veins
➔ Femoral veins
➢ Large vessels on the thigh
➢ Collects deoxygenated blood from
tissues in the lower leg and helps
move it to the heart to make it
oxygenated, and moves back out of
the body through the arteries
➢ If the pregnant mother confines herself
in one position for several hours, blood
flow from the femoral veins will be
obstructed

❖ DIETARY MANAGEMENT ➢ Obstruction will lead to leaking of fluid

● DIET from the blood to the legs causing
1. HIFIBER DIET edema
➢ More fruits and vegetables
❖ DIETARY MANAGEMENT
2. INCREASE FLUID INTAKE ● DIET
➢ At least 8 glasses of liquids per day. 1. Moderate sodium ( 2000mg/day )
➢ Less consumption of salty foods such
● MANAGEMENT as:
1. Exercise daily ➢ Sauces, condiments and gravies
canned goods, processed foods
2. Respond promptly to the urge to defecate with preservatives

3. Use laxative only as prescribed by a ➢ Consume natural sodium containing

physician foods
➢ Because sodium contributes to
water retention because it attracts
water.

VIANNE PALMA I 12
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

➢ At the same time, it will harden the ● Give more on nutrient density rather than
vessels that leads to the energy density foods, give complex CHO.
contraction of the flow of the blood
and water ● Make your cravings constructive

● Eat balanced meals and refuel often

● MANAGEMENT
1. Enough rest 2. UNDERWEIGHT
● Additional calories and CHON must be
2. Lying down position when sleeping to
followed.
mobilize extravascular fluid and activation
of the urination process. ● Give nutrient–energy density food
5. LEG CRAMPS 7. PREGNANCY-INDUCED HYPERTENSION (PIH)
❖ Changes in the blood circulation and stress on the ❖ Or the gestational hypertension in which rapid
leg muscles carrying extra weight and may burden weight gain is one of the main causes.
the gastrocnemius muscle, which will contract and
give pain reaction ❖ High blood pressure during pregnancy may cause
intrauterine growth restriction.
❖ The growing baby also put pressure on the nerves ● Intrauterine growth restriction (IGR)
and blood vessels that go to the legs ➔ When the baby or fetus does not grow as
expected
❖ According to doctors, there is imbalance between
calcium levels caused by calcium or magnesium ➔ Poor growth of a baby in the mother’s
deficiency womb
1. There is a sudden contraction of gastrocnemius ➔ Happens if the baby does not receive the
muscle. necessary nutrients and oxygen needed
➢ The baby is deprived with nutrient and
2. This is due to decline in serum Ca levels related to
oxygen supply for growth and
Ca – Mg imbalance or caused by calcium or
development of organs and tissue
magnesium deficiency
❖ RECOMMENDED FOODS:
❖ DIETARY MANAGEMENT
● 2 or more fresh fruits
● DIET
1. Give Ca rich foods ● Vegetables and dairy products
2. Give P rich foods ● More white meat instead of red meat
3. Give Mg rich foods ● Whole grains instead of refined grains
● MANAGEMENT ❖ CHARACTERIZED INTO:
1. Stretch your calf muscles, stretching ● Preeclampsia
before bed
● Eclampsia
2. Stay active. Regular physical activity.
❖ Symptoms:
3. Stay hydrated. ● Mild preeclampsia
➔ High blood pressure
4. Choose proper footwear.
➔ Water retention protein in the urine
6. RAPID WEIGHT GAIN OR LOSS DIETARY
MANAGEMENT ● Severe preeclampsia or Eclampsia
1. OBESE ➔ Headaches
● Rapid weight gain may result from excess food
intake and lack of physical activity. ➔ Blurred vision

● No addition of calories and CHON ➔ Inability to tolerate bright light

➔ Nausea/vomiting

VIANNE PALMA I 13
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

➔ Urinating small amounts ● If the mother doesn't have any habits to

develop and she has heredity of DM, it will
➔ Pain in the upper right abdomen continue even after pregnancy
➔ Shortness of breath
❖ Hormones made by the placenta such as estrogen,
➔ Seizures cortisol, and human placental lactogen can have a
blocking effect on insulin (contra-insulin effect) may
➔ Convulsion result in glucose build up in the blood instead of
being used by the cells.
❖ DIETARY MANAGEMENT ● Contra-insulin effect
1. Optimum nutrition ➔ Blocking effect of insulin
➔ Enough and adequate supply of essential
nutrients and the body will efficiently utilize ➔ Insulin act as a receptor to make glucose
it for growth and development enter the cell to be used as energy, but
2. CHON – HBV (High Biological Value Proteins) because of this pregnancy hormone, it will
➔ In moderate amount block the function of insulin, and may lead
in the accumulation of glucose in the blood
➔ These are red meats and egg yolk ➢ The fetus is high risk for glucose
mediated macrosomia
3. Supplementations
1. Fe ➔ Human chorionic somatotropin interfere
➢ Dark green leafy vegetables with insulin directed entry of glucose into
the cells
2. Ca
➢ Rich foods like dairy products like:
➔ High risk of glucose mediated macrosomia
milk, curd, soya milk
happens because extra glucose in the
3. Vitamin A fetus is stored as body fat causing
➢ Carrots, egg, pumpkins, spinach, macrosomia also called as large for
green leafy vegetables. gestational age
➢ Glucose in the blood mapasa sa baby,
4. Salt restricted diet kaya genetic or hereditary ang DM
➢ Sodium in salt will stiffen and hardens
the blood vessels that aggravates ➢ If the mother is diabetic, it can be
congestion of blood pathways passed on unto the baby

8. ANEMIA ❖ Fetus is at higher risk of glucose-mediated

❖ Resulted from the deficiencies of iron and folic acid macrosomia.
❖ DIETARY MANAGEMENT ❖ DIETARY MANAGEMENT
● Iron Supplementation
1. Give complex carbohydrates, more in green
● Folic acid Supplementation leafy vegetables

● Vitamin C Supplementation 2. Avoid foods that are high in glycemic index

1. Eat foods rich in heme 3. HIFIBER diet

➔ Sources of iron are high biological value
proteins (HBV), but shouldn’t give larger 4. Avoid products that use added sugar and trans
amounts of these to clients fats.

➔ Liver and egg yolk ADOLESCENT PREGNANCY

❖ Nutrient deficiencies
2. More on dark green leafy vegetable
1. Vitamins A , D, Folate
9. GESTATIONAL DM
2. Minerals Fe, Zn, Ca
❖ May result as temporary response to stress of
pregnancy and it disappears after the baby is born

VIANNE PALMA I 14
 SAN PEDRO COLLEGE
BACHELOR OF SCIENCE IN NURSING
MIDTERMS
NUTRITION AND DIET THERAPY
PROF: MARIETA HILARIO

❖ RISK IN ADOLESCENT PREGNANCY

● Giving birth to LBW babies, Preterm deliveries
and Severe Neonatal conditions

● Because adolescent mother’s physical and

mental growth, and maturity of personality are
not completed yet.

● Because the uterus did not reach its full

maturity and was not capable of handling
pregnancy.
➔ The source of nourishment for the baby is
the uterine substances if the maternal
tissue, and the development of the
placenta depends on the nourishment of
the mother

● Because adolescents need to meet their own

nutritional requirements for their own growth
and development.

VIANNE PALMA I 15