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Side effects of contraceptives) what are the side effects of oral contraceptives? (7)
- increase HDL
-increase LDL, TG, total cholesterol
-increase in blood clots
-increase risk in cervical cancer
-decrease blood levels of B6
-decrease blood levels of b12
-increase blood levels of copper
-
Side effects of contraceptives) first year side effects for injections (5)
-weight gain
-irregular periods
-fatigue
-headache
-abdominal pain
-
Side effects of contraceptives) long term side effects of injections (4)
- decrease bone density
-decrease HDL choelsterol
-increase in LDL cholesterol
-increase in insulin levels
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Side effects of contraceptives) what are some high rate of side effects in implants use (3)
-erratic bleeding
-weight gain
-headaches
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Side effects of contraceptives) side effects of using contraceptive patch (6)
-increase in cholesterol and TG
-increase HDL
-breast soreness
-headaches
-abdominal pain
-application site reactions
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PCOS) what is significant about PCOS and infertility?
It is the leading cause of infertility
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PCOS) how is characterized by? (10)
-insulin resistance
-high blood insulin levels
-high testosterone levels
-obesity
-polycystic ovaries
-menstrual dysfunction
-amenorrhea
-infertility
-hirutism
-acne
-
PCOS) 4 ways to manage the syndrome
-increase insulin sensitivity
- -lifestyle modifications
- *leading a healthy life
-insulting sensitizing meds
-may also use drugs to stimulate ovulation
-
PCOS) incorporating exercise and weight loss as a lifestyle odficiation will do what?
-improve insulin sensitivity
-decrease blood lipids and insulin levels
-decrease glucose
-decrease testosterone levels
-
PCOS) incorporating a better nutrition as a lifestyle modification would entail...(6)
Eat more..
-omega 3
-whole grains
-fruits and veggies
-non-fat dairy products
-regular meals
-Low-GI foods
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Nutritional recommendations for hypertension during pregnancy) nutritional interventions for chronic hypertension (3)
-weight gain recommendations are the same
-DASH diet
-if salt sensitive, then moderate salt intake
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) what percent should protein comprise of from total calories?
20%
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Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) what is RDA for vitamin A
770 mg
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Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) what is RDA for vitamin D
5 mg or 200 IU
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) what is RDA for b12?
2.6 mg/day
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) RDA for b6?
1.9 mg/day
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) RDA for thiamin
1.4 mg/day
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) RDA for niacin
18 mg/day
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) RDA for riboflavin
1.4 mg/day
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) RDA for pantothenic acid
6 mg/day
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) RDA for calcium
1000 mg/day
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) RDA for zinc
11 mg
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Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) RDA for iron
27 mg/day
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) RDA for iodine
220 mg.day
-
Approximate nutritional needs for proteins, calories, micronutrients for pregnancy) RDA for EPA and dha
300 mg
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Potential effects of maternal obesity on mom and baby) children of obese women are at risk of (6)
-macrosomia
-low apgar scores
-shoulder dystocia
-childhood obesity
-difficulty regulating blood sugar after delivery
-perinatal mortality due to greater difficulty with delivery
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Potential effects of maternal obesity on mom and baby) obese women are at greater risk for...(5)
-hypertension
-gestational diabetes
-induced labor
-prolonged labor
-c-section
-
Potential effects of a low and high BMI in fertility ) both of these increases chances of
Infertility
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Potential effects of a low and high BMI in fertility ) low BMI lead to hypothalamic amenorrhea.. which is..? (3)
-deficits in energy and possibly nutrients lead to hormonal changes that prevent ovulation
-menstrual irregularities can last months to years
**usually weight gain restores fertility
-
Potential effects of a low and high BMI in fertility ) acute nutrition and infertility (2)
Reduces reproductive capacity bc it leads to hormonal signals that regulate menstrual cycle to change and imparts sperm maturation in males
-
Potential effects of a low and high BMI in fertility ) effects on obese men that lead to infertility (4)
- decreased trestosterone
-decreased in SHBG
-increase leptin
-decrease sperm count
-
Potential effects of a low and high BMI in fertility ) effects that occur to obese women that lead to infertility (4)
-increase estrogen
-increase androgens
-increase leptin
-decrease SHBG
-
SHIFT in fuel usage during pregnancy accelerated fasting metabolism) summary about this
-in the first half, women are laying down fat stores because the body will be turning these fat stores into glucose in the 2nd half of pregnancy due to the fetus demanding more glucose. Once body starts using glycolysis, mild ketosis may occur after an overnight fast.
-
What is the RDA for folate?
600 mcg dfe/day
-
Physiology of the placenta) what is a placenta
Bed of tissue that forms between the uterine wall to provide an interface between maternal and fetal circulatory systems
*structure is designed to prevent fetal and mother blood from touching
-
Physiology of the placenta) where does exchange of materials occur?
Within sponge like endometrium through active or passive transport
-
Physiology of the placenta) what functions does the placenta provide? (3)
-respiratory
-absorptive
-excretory
-
Things to avoid during pregnancy) 4 things to avoid
-alcohol
-smoking
-lead exposure
-excessive vitamin A
-
Nutritional recommendations for gestational diabetes) nutritional recommendations on components of nutritional management (5)
-assessing dietary and exercise habits
-developing an individual diet and exercise plan for blood glucose control
-monitoring weight gain
-interpreting blood glucose and urinary ketone results
-ensuring follow up during pregnancy and post partum
-
Nutritional recommendations for gestational diabetes) goals of nutritional therapy (3)
-well controlled blood glucose levels
-hemoglobin A1c less than 7%
-reduction of risk of developing diabetes, HTN, heart disease, and obesity
-
Nutritional recommendations for gestational diabetes) nutritional approach (5)
-whole grain breads/ cereals, veggies, fruits, high fiber foods
-limited intake of simple sugars and foods that contain them
-low GI foods
-monounsaturated fats
-regular meals and snack daily
-
Categorizations of pre-term, gestational age) what is classified as a pre-term baby?
Infants born less than 37 weeks gestation
-
Categorizations of pre-term, gestational age) 2 categories under small for gestational age
-disproportionally small for gestational age
-proportionally small for gestational age
-
Categorizations of pre-term, gestational age) characteristics of disproportionally small for gestational age (4)
-weigh less 10%ile of weight for gestational age
-growth retardation primarily affecting weight
-have normal length and head circumference for age
-infants have poor developed muscles and almost no subcutaneous fat
*** most likely occurred at the end
-
Categorizations of pre-term, gestational age) Proportionally small for gestational age (3)
-look small but well proportioned
-growth reduction in both weight and height
-size of all parts of body are reduced proportionally
***most likely experienced malnutrition throughout the whole term
-
Categorizations of pre-term, gestational age) large for gestational age (3)
-infants that weigh more than 90%ile for gestational age
-may be related to pre-pregnancy obesity, poorly controlled DM, excessive weight gain
-delivery tends to get complicated but these infants have lower illness rates
-
PMS) description of pms?
Cluster of physical, emotional, psychological symptoms that some women experience prior to their menstrual cycle
-
PMS) physical signs of pmsq (6)
-fatigue
-abdominal bloating
-swelling of the hands of feet
-headache
-tender breasts
-nausea
-
PMS) psychological symptoms (6)
-craving for sweet or salty foods
-depression
-irritability
-mood swings
-anxiety
-social withdrwal
-
PMS) what are probable causes? (3)
-abnormal serotonin activity following ovulation
- hormonal changes of menstrual cycle
- low intake of vitamin d and calcium
-
PMS) what has been shown to alleviate this? (6)
- increase b6
-increase magnesium
-exercise and stress reduction
- reducing caffeine
-increasing vitamin d and calcium
- taking antidepressants
-
Hormones involved in fertility/infertility) if a normal weight woman loses 10-15% weight... which hormones are affected?
-decreased estrogen
-decreased LH
-decreased FSH
**results in amenorrhea, anovulatory cycles, short or absent luteal phases
-
Hormones involved in fertility/infertility) in men, obesity does what to 4 hormones?
-decreases testosterone
-decrease SHBG
-increases leptin
-decreases sperm count
-
Hormones involved in fertility/infertility) in obese women, what haoppoens to 4 hormones?
-increases estrogen
-increases androgens
-increases leptin
-decreases SHBG
-
Hormones involved in fertility/infertility) wants the consequence of obesity leading to insulin resistance?
Insulin can stimulate testosterone production which will lead to ovulatory dysfunction
-
Hormones involved in fertility/infertility) for obese men, what did losing weight result in?
Increase in SHBG
-
Hormones involved in fertility/infertility) in obese women, what did losing weight result in? (3)
- -Increase SHBG
- -decrease in estrogen
- -insulin resistance
-
WIC) description of WIC
- Provides nutrition education, supplementary foods, and referrals to health and social services to economically disadvantage women who are pregnant, post partum, or caring for infants under age of 5
- **provides food vouchers for the needy ones
-
WIC) how is eligibility based on? (2)
Low income status and the presence of a nutritional risk
-
WIC) what are some of positive effects from this program (3)
-infants weigh more, less likely to be SGA at birth, less likely to be preterm baby
-children in WIC consume more nutriotus foods and lower iron deficiency
-cost effective on saving in Medicaid costs
-
Factors that can affect infertility) (5)
-undernutrition
-obesity
-over-exercising
-effect of nutrients
-male fertility issues
-
Benefits of breast milk) breastfeeding benefits to infants PART I (4)
-provides optimal nutrition to the infant
- -isosmotic
- *provides fluid and food reqs
-low protein content thus does not tax kidneys of infatn
-whey protein is easily digestible
-
Benefits of breast milk) breastfeeding benefits to infants PART II (3)
-provides lipids like essential fatty acids, saturated fatty acids, medium chain triglycerides, chleosterol
-long chain polyunsaturated fats and DHA promote development of CNS
-minerals are balanced to meet infant needs
-
Benefits of breast milk) breastfeeding benefits to infants beyong 6 months (5)
-provides optimal nutrition
-fresh safe milk
-enhances immune system
-protects against infectious diseases
-protects against allergies and intolerances
-
Benefits of breast milk) breastfeeding benefits to infants beyong 6 months (6) PART II
-decreases risk of diarrhea and respiratory infections
-promotes correct development of mouth
-decreases risk of childhood obesity
-increases cognitive function
-reeudecs risk for heart disease
-increases bonding with mother
-immunological beenfits
-
Morning sickness) how to treat ? (5)
-small, frequent meals
-separate food and liquid
-avoid offensive odors
-get fresh air
-high carbs foods tend to be well tolerated
-
Morning sickness) how is this caused?
Caused by increased levels of HCG, progesterone, estrogen, and other hormones in early pregnancy
-
Morning sickness) what are 3 supplements that may help treat it?
-vitamin b6
-multivitamin supplements
-ginger
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FDA recommendations for fish intake during pregnancy)
-eat less than 12 ozs a week of fish and shellfish that are low in mercury
-
Contraindications for breastfeeding) (7)
-exposure to environmental contaminants
-use of illegal drugs
-use of alcohol or nicotine
-active tuberculosis
-HIV or AIDS
-meds such as radioactive isotopes, anti-metabolites, cancer chemo agents, lithium, ergotamine
-always check drugs, and herbal medications for safety
-
Physiological stages of change during pregnancy) blood volume and composition (2)
-plasma volume surges thus making mother tired
-hematocrit and hemoglobin appear to decrease bc RBC production as much as plasma volume
-
Physiological stages of change during pregnancy) cardiovascular system
-heart grows slightly larger due to increased blood volume and cardiac output
-
Physiological stages of change during pregnancy) respiration (2)
-thoracic breathing replaces abdominal breathing
-breathes deeper and may have to take extra breaths
-
Physiological stages of change during pregnancy) renal function
-kidneys must mange the increased metabolic, circulatory and excretory demands of the body
-
Physiological stages of change during pregnancy) metabolic adjustments
-Basal metabolic rate increases
-
Physiological stages of change during pregnancy) first half pregnancy of carbs metabolism
-increases insulin production to lay down fat stores and convert glucose to glycogen and fat
-
Physiological stages of change during pregnancy) 2nd half of pregnancy in carbs metabolism (3)
-stops converting glucose to glycogen + fat
-insulin resistance rises in mother making her rely on fat stores
-increase of glucose production in the liver
-
Physiological stages of change during pregnancy) protein metabolisms
-increased need for nitrogen and protein for synthesis of maternal and fetal tissues
-
Physiological stages of change during pregnancy) calcium metabolism
-increased rate of bone turnover and reformation
-
Physiological stages of change during pregnancy) sodium and other mineral
Increased reqs due to elevated levels of body water and tissue synthesis
-
Physiological stages of change during pregnancy) GI function (7)
-appetite increases
-nausea/vomiting may occur
- -GI motility is dimished
- *constipation
-intestinal secretion reduced
-sense of tastes altered
-absorption of nutrients enhanced
- -decrease in smooth muscle of GI tract
- *constipation and heartburn
-
Fetal origins of later disease risk theory ) what is the theory based on?
- That exposure to adverse nutritional and other conditions during critical periods of growth can permanently affect body structures and functions
- *these changes will predisposed the individual for later
-
Fetal-origins hypothesis of later disease)what has studies shown us about smaller infants and chronic diseases later in life?
The smaller the infant the more likely they will have an issue like heart or stroke
-
Fetal-origins hypothesis of later disease) what happens if there are less than optimal conditions during gestation? (1+2)
Fetal tissues make adaptations to cope with energy and nutrient excesses and shortages
-this allows to change reqs for energy and nutrients to allow it to survive
-biologically preparing fetus for similar conditions after birth
***nutrition programming
-
Fetal-origins hypothesis of later disease) adaptations to ensure CNS is receiving adequate glucose during glucose limited times...
expression of genes may suppress insulin receptors to increase insulin resistance and therefore decrease glucose uptake so more is available for cns
-
Approximate nutritional needs for breastfeeding) DRIs for normal weight lactating women- how many calories per day in first 6 months? What about afterwarffds?
-500 kcal/day ; 400 kcal/day
-
Approximate nutritional needs for breastfeeding) based on 2400 kcal (7)
-8 oz grains
-3 cups veggies
-2 cups fruits
-3 cups milks
-6.5 oz of meat and beans
7 teaspoons of oil
-360 kcal in deseerts, fats, sweets
-
What effects the quantity and quality of breast milk)
-depends on maternal nutritional status
-
Recommendations to encourage a woman to begin, continue breastfeeding) (5)
-promote it as a norm for feeding infant
-collaborate with others who promote breastfeeding
-initiate/support breast feeding campaigns
-conduct empirical research
-educate prenatal and postpartum women on breastfeeding.
-
Potential barriers to breastfeeding) (7)
-embarrassment
-time and social constraints
-concerns about loss of freedom
-lack of support
-lack of confidence
-concerns about diet and health practices
-fear of pain
-
Chart on pregnancy weight gain recommendations) underweight ( less 18.5)
28-40
-
Chart on pregnancy weight gain recommendations) normal weight (18.5-24.9)
25-35
-
Chart on pregnancy weight gain recommendations) over weight (25-29.9)
15-25
-
Chart on pregnancy weight gain recommendations) obese
15
-
Chart on pregnancy weight gain recommendations) twin pregnancy
35-45
-
Rate of weight gain) (2)
-first semester= 3-5 lbs
-1 pound a week after that
-
Recommended intake for folate
600 mcg
-
Recommended for folic acid
400
-
Which is easier to digest folic acid or folate?
Folic acid
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