Nutritional care Component of nutriental care ( assesment - | الدفعة 38 المجموعة "2" (دفعة روان عبدالحميد)

Nutritional care

Component of nutriental care ( assesment - education _ supplimintation- correction of deficiency )
nutritional assessment
History=screening questionnaire
Score 0=health eating habits
Score 1= less health eating habits
Score 2= least health eating habits
Summary score range from 0_16
Lower numberd indicate good habits
higher number indicate bad habits

جدول مهم بتاع body mass index
0.5 _ 2 kg weight gain in first trimester
lab investigation
Hemoglobin/hematocrit....
Check at first prenatal visit
Late second trimester
Early third trimester
بص علي قيم بتاع ال anmia
vitamin D not necessary to be done
measurements is reasonable
(Obese- minimum sin exposure - malabsorptive disease)

food Guide Pyramid
Base ( rice ..pasta..bread..cereal )
Second layer (vegetables and fruits )
Third layer (milk group cheese yogurt ) and meet .. poultry..egg )
Fourth layer ( fat ..oil ..suger)

supplimintation-

1_ routine in pregnancy iron and folic acid after third trimester
200 mg ferrous fumurate
400 ug folic acid
2 At high risk of neural tube defect should receive 4 mg folic acid prior to consepaton and first 12 weeks

3. Vitamin A above 700 teratogen
4 ca (second trimester )500mg
most common deficiency is anamia
Indication to iron iv ..
1 cannot tolerate oral iron
2 sevee symptomatic anamia
3 impaired absorption of oral
Expected response to iron
1 start reticulocytosis with week
2 increase Hb with two weeks
3 return s ferritin to normal .

indication of referal in iron deficiency anaemia
..HB <7
Intolerance to oral iron
Presist anmia
most common cause of megaloblastic anmia is folic acid deficiency
effect of folic acid deficiency
Neural tube defect
Spina bifida
Anencephaly
supplimintation-of folic acid is recommended at (periconceptional and first trimester )0.4 mg
all women in childbearing should receive folic acid once per day
Previous pregnancy by NTD
= 4 mg of folic acid every day
Prior to conception and in first
Trimester
Then decrease dose to (0.4 )
After first trimester.

measurement of folic acid before and after supplimintation-is not recommended