Pregnancy
Nutrition issues associated with pregnancy
- Underweight
- Overweight
- Anemia
General information
Mrs. Harriet is 35 years old. She is in her third trimester of pregnancy. This is the first time she has visited this clinic for nutrition assessments.
Medical history
- Present illness
Harriet’s illness started to manifest itself in her second trimester of pregnancy. She began experiencing;
- Rapid weekly weight gain
- unusual thirst.
- Excessive fatigue
- Sugar in the urine
These signs are consistency with gestational diabetes also known as high blood sugar which the patient was later diagnosed with.
Complications associated with gestational diabetes
- Women suffering from this condition have very high chances of undergoing caesarian delivery.
- This condition increases the probability of suffering from preeclampsia, that is protein in the urine.
Risk factors associated with gestational diabetes
- Obesity
- The occurrence of the same condition in the previous pregnancy
- If a mother had delivered a child previously weighing over nine pounds
- Past illnesses and hospitalization
- Harriet had suffered from childhood diseases common to other children (chickenpox in particular)
- Harriet never suffered from food allergies, but she experiences allergies when she uses some medicines, e.g. mefenamic acid.
The last time she was admitted to hospital dates back to 2015 July having suffered from pneumonia.
- Physical state and health
- The patient complains of losing appetite in eating
- The patient also suffers from indigestion
- Family medical background
No chronic illness could be traced to Harriet’s family. Her father had died the previous year aged 90 years. The cause of his death is attributed to old age. Her mother, still alive, suffers from cardiac arrest at times.
- Social-economic background
Mrs. Harriet lives in Washington Waitsburg in a rented apartment with her family of four (her husband, two daughters and one son). Her pregnancy which has made her go on leave from her office job. Her earnings are average $5,000 with an additional house and transport allowances.
Mrs. Harriet attended Harvard University and was awarded an undergraduate’s degree in commerce twelve years ago. Currently, she is enrolled as a part-time master’s student.
Mrs. Harriet was born from a God-fearing Christianity background. She is born again and also baptized.
Anthropometric assessments
Body Mass Index (BMI) (weight/height) 27.9
Pregnancy weight during the initial visit 80kgs
Initial visit week of gestation week 29
Body height 170.18cm (2.89m2)
Body weight before pregnancy 60kgs
For the subsequent coming weeks, Prenatal Weight Gain Chart will be used to track down the weight of the patient.
| Pregnancy BMI | Recommended weight gain range | |
| Underweight | <18.5 | 28-40 lb. |
| Normal weight | 18.5-24.9 | 25-35 lb. |
| Overweight | 25-29.9 | 15-25 lb. |
| obese | >=30 | 11-20 lb. |
According to this Pregnancy BMI, Mrs. Harriet recorded a score of 27.9 which falls in the category of overweight pregnant patients. It seems clear that she never had a medical provider who would help her set goals for weight gains before it became a problem.
Biomechanical assessments
| Laboratory values | Normal values | variations | The rationale for the variations |
| SGPT/ALT
(80) |
0-48 U/L | high | Congestive heart failure |
| Creatinine
(122.2) |
62-115 mm0L/L | High | High intakes of proteins |
| RBS/CBG
(310) |
>310mg/day | High | High levels of blood sugars. |
| ALP
(76) |
40-150 U/L | normal | The functionality of the liver is normal |
Clinical assessments
| Body part | Clinical sign | Nutritional deficiency |
| skin | dry | vitamins |
| Eyes | Yellowish | Vitamin A |
| Extremities muscles | Slow response | potassium |
Dietary assessment
Mrs. Harriet favorite food is rice and beef which she consumes mostly in her lunch and dinner diets. In her breakfast, she is served with fried fish or eggs. Therefore, her diet is mostly comprised of fat and proteins. Mrs. Harriet lack vitamins in her diet which are very important in the body as they act as catalysts for fat metabolisms. Although the things mentioned in this section are her favorites, she dislikes no food. She consumes a lot of snacks which might be responsible for the weight increases. She is non-allergic to any form of food.
The dietary that is required in Mrs. Harriet’s menu is to consume foods with low fats and increase the rate of consumption of vitamins. She should supplement her eating a diet with fruits.
Medication plan
The patient should take metformin tablets to lower the levels of glucose by stimulating the liver in reducing levels of glucose produced. For advanced complications, macrosomia or hydramnios, the patient should undergo insulin medication as well as a modified diet plan. For insulin medication, glibenclamiide tablets are used in stimulating the pancreas’ production of more insulin.
Nutrition care plan
The objectives and goal settings of this nutrition plan are to help Mrs. Harriet in losing the excessive 15kg in a span of the remaining gestation period before delivery. This nutrition plan is also geared towards ensuring that she has balanced blood sugars in her body.
| parameters | Nutrition problems | Problems not related to nutrition |
| Anthropometric | null | null |
| Biomechanical |
· Malnutrition · Breakdown of proteins
|
Liver complications |
| Clinical | · Vitamins deficiency
· Minerals deficiencies
|
null |
| Dietary | · Vitamins deficiencies
· Minerals deficiencies |
null |
Diet prescription analysis
The patient should concentrate on taking foods with low fats. The patient should also ensure she consumes food with low levels of salt to help in balancing body fluids glucose. Low-fat diets will assist in achieving the target of reducing excessive weight. The diets prescribed below will ensure that the patient will hit the two goals on time.
| Breakfast | Lunch | Supper |
| One medium banana
1 fat-free glass milk 2/3c bran cereal |
1/4c chicken salad
One glass fruit cocktail juice One slice of white bread |
Small baked potato
Tsp soft margarine Green beans Wheat roll small in size |
| For snacks consumption
One glass Orange juice 1/4raisins One glass of fat-free yoghurt Additional information · The patient should consume fluids with low sugar levels · The patient should also consume food with low levels of salt
|
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References