A nurse is caring for a young adult client who is discontinuing birth control pills and wishes to start a family. Which of the following statements by the nurse is an appropriate dietary guideline?
Increase your caloric intake before pregnancy to stabilize your metabolism.
Increase your total intake of seafood to 20 ounces per week.
Decrease ascorbic acid in your diet.
Increase folic acid to 400 micrograms per day prior to getting pregnant.
The Correct Answer is D
Choice A reason: Increasing the caloric intake before pregnancy is not an appropriate dietary guideline, as it can lead to excessive weight gain and obesity, which can increase the risk of gestational diabetes, hypertension, and other complications. The nurse should advise the client to maintain a healthy weight and a balanced diet before and during pregnancy.
Choice B reason: Increasing the total intake of seafood to 20 ounces per week is not an appropriate dietary guideline, as it can expose the client to high levels of mercury, which can harm the developing fetus. The nurse should advise the client to limit the intake of seafood to 8 to 12 ounces per week, and avoid fish that are high in mercury, such as shark, swordfish, and king mackerel.
Choice C reason: Decreasing ascorbic acid in the diet is not an appropriate dietary guideline, as it can impair the immune system and the absorption of iron, which are both important for the health of the mother and the fetus. The nurse should advise the client to consume adequate amounts of ascorbic acid, which is found in citrus fruits, tomatoes, broccoli, and other foods.
Choice D reason: Increasing folic acid to 400 micrograms per day prior to getting pregnant is an appropriate dietary guideline, as it can prevent neural tube defects, such as spina bifida and anencephaly, in the fetus. The nurse should advise the client to take a daily prenatal vitamin that contains folic acid, and eat foods that are rich in folate, such as leafy greens, beans, and fortified cereals.
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Correct Answer is D
Explanation
Choice A reason: Offering the client a selection of beverages at each meal is not a good action to include in the plan, as it may reduce the client's appetite and intake of solid foods. The nurse should limit the client's fluid intake before and during meals, and encourage the client to consume high-calorie and high-protein drinks, such as milkshakes or smoothies, after meals.
Choice B reason: Informing the client that a weight gain of 2.3 kg (5 lb) per week is expected is not a good action to include in the plan, as it may cause anxiety and resistance in the client. The nurse should set realistic and individualized weight goals for the client, and monitor the client's weight and vital signs regularly. The nurse should also avoid focusing on the client's weight, and instead emphasize the client's health and well-being.
Choice C reason: Arranging for someone to remain with the client for 30 min after meals is a good action to include in the plan, as it can prevent the client from purging or exercising excessively. The nurse should provide a supportive and nonjudgmental environment for the client, and supervise the client's eating and toileting behaviors. The nurse should also educate the client and the family about the complications and treatment of anorexia nervosa.
Choice D reason: Encouraging the client to participate in developing dietary goals is a good action to include in the plan, as it can increase the client's sense of control and motivation. The nurse should collaborate with the client, the dietitian, and the mental health team to create a personalized and flexible meal plan that meets the client's nutritional and psychological needs. The nurse should also praise the client for any progress or achievement, and reinforce the client's positive coping skills.
Correct Answer is B
Explanation
Choice B reason: Lentils are a rich source of folate, which is a B vitamin that is essential for the development of the neural tube and the prevention of neural tube defects in the fetus . One cup of cooked lentils provides about 358 micrograms of folate, which is 90% of the recommended daily intake for pregnant women.
Choice A reason: Mashed potatoes are not a good source of folate, as they contain only 8 micrograms of folate per cup, which is 2% of the recommended daily intake for pregnant women. Potatoes are mainly a source of carbohydrates, potassium, and vitamin C.
Choice C reason: Green peppers are a moderate source of folate, as they contain 42 micrograms of folate per cup, which is 11% of the recommended daily intake for pregnant women. Green peppers are also a source of vitamin C, vitamin A, and fiber.
Choice D reason: Carrots are a low source of folate, as they contain 24 micrograms of folate per cup, which is 6% of the recommended daily intake for pregnant women. Carrots are mainly a source of vitamin A, beta-carotene, and fiber.
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