Hi, I'm Cathy with Level Up RN. In this video, I'm going to continue my coverage of topics from our Level Up RN Nutrition Flashcard deck. Specifically, I'll be talking about nutrition during pregnancy. And at the end of the video, I'm going to give you guys a quiz to test your understanding of some of the key points I'll be covering. So definitely stay tuned for that. And if you have our flashcards, go ahead and pull them out so you can follow along with me and pay close attention to the bold red text on the back of the cards because those are the things that you are likely to get tested on.
There are a number of key nutrients that are needed during pregnancy to promote fetal growth and development. The first and probably one of the most important nutrients and one you are definitely going to get tested on in nursing school is folic acid. Folic acid should be taken for at least one month prior to becoming pregnant and for the first three months of pregnancy in order to prevent neural tube defects. So these are major defects that affect the brain and spinal cord. 600 micrograms of folic acid are needed per day. And since it is difficult to get that much from food alone, a prenatal vitamin that contains at least 400 micrograms of folic acid is recommended. Our cool chicken hint to help you remember this nutrient is folic acid prevents fetal problems. Protein is also essential during pregnancy to support the growth of fetal tissues. Protein intake should be increased to 60 grams per day.
And then next, we have iron, which is essential for the development of red blood cells, which supply oxygen to the fetus. Intake should be increased to 27 milligrams per day. This amount can be found in most prenatal vitamins, but an iron supplement, such as ferrous sulfate, may be recommended by the provider as well. As a reminder, taking an iron supplement with vitamin C helps to increase absorption of iron.
Calcium is also needed during pregnancy to support the formation of bones and teeth in the developing fetus. 1,000 milligrams of calcium per day is recommended. In addition, vitamin D is needed for the absorption of calcium. So 600 IU or international units of vitamin D are recommended each day as well. 2 to 3 liters of fluid intake is recommended each day, alcohol should be avoided, and caffeine intake should be limited to under 200 milligrams per day. And then finally, pregnant patients should avoid fish that are high in mercury and limit their intake of albacore tuna to less than six ounces per week.
In terms of the recommended weight gain during pregnancy, an average weight individual should gain a total of 25 to 35 pounds during pregnancy. An underweight individual will need to gain a little more, so between 28 and 40 pounds. And then an overweight individual can gain a little less, so between 15 and 25 pounds. During the first trimester, when the fetus is teeny-tiny, a total weight gain between 1 and 4 pounds is expected during those three months. Then during the second and third trimesters, a weight gain of 1 pound per week is expected.
Let's now talk about extra calories needed during pregnancy and with breastfeeding. So during the first trimester of pregnancy, no additional calories are needed. During the second trimester, an additional 340 calories per day is recommended. And during the third trimester of pregnancy, an additional 450 calories per day is recommended. And then breastfeeding requires an additional 450 to 500 calories per day.
Let's now touch on nutrition for some key pregnancy disorders. The first disorder we're going to talk about is phenylketonuria, or PKU. This is a genetic condition that causes elevated levels of phenylalanine, which is an amino acid, in the body. So if PKU is uncontrolled and levels of phenylalanine are elevated during pregnancy, this can result in serious congenital defects as well as intellectual disability in the developing fetus. So if a mother has PKU, they will need to follow a strict low phenylalanine diet, which is low in protein, and also have their levels of phenylalanine monitored throughout pregnancy. Our cool chicken hint to help you remember this is with PKU, protein can kill your baby, with your being UR because we're a gangster over here.
Next, let's talk about gestational diabetes, which is impaired glucose tolerance during pregnancy that increases the risk of complications in the infant, such as macrosomia, which is an infant that is larger than normal, as well as hypoglycemia, just to name a few. An individual with gestational diabetes will need to closely monitor their blood glucose levels throughout pregnancy, follow a carbohydrate-controlled diet, and possibly take insulin as prescribed.
Lastly, let's talk about hyperemesis gravidarum, which is a disorder that causes severe nausea and vomiting during pregnancy. It can lead to complications such as dehydration and electrolyte imbalances. Some things that may improve symptoms of hyperemesis include consuming smaller, more frequent meals as opposed to three larger meals, drinking liquids between meals as opposed to with meals, eating room-temperature or chilled foods, consuming readily digestible low-fat carbohydrates such as dry toast, avoiding high-fat foods, and then avoiding foods and drinks that have strong smells.
All right. It's quiz time. Are you guys ready? I've got five questions for you this time because we went over a lot of important information.
Question number 1. What nutrient needs to be taken prior to pregnancy and during the first trimester of pregnancy to prevent neural tube defects?
The answer is folic acid.
Question number 2. How much weight should an average weight patient gain during pregnancy?
The answer is between 25 and 35 pounds.
Question number 3. How many extra calories are needed per day during the first trimester of pregnancy?
The answer is no extra calories are required.
Question number 4. What vitamin increases absorption of iron?
The answer is vitamin C.
Question number 5. A pregnant person with PKU needs to consume a low phenylalanine diet, which is low in blank.
The answer is protein.
All right. That's it for this video. I hope it was helpful. Take care and good luck with studying.
[BLOOPERS]
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