A nurse is providing nutritional advice to a woman considering pregnancy.
What information should the nurse include to minimize the risk of having a newborn with a neural tube defect?

Choice A rationale

A 38-year-old client who reports smoking one pack of cigarettes every day. Oral contraceptives are contraindicated in women who are over 35 years old and smoke. This is because the combination of oral contraceptives and smoking increases the risk of serious cardiovascular side effects, such as blood clots, stroke, or heart attack. These risks are even higher in women over 35 years old who smoke. Therefore, this client should not receive oral contraceptives due to the increased risk of these serious side effects.

Choice B rationale

A 28-year-old client who has a history of pelvic inflammatory disease. While pelvic inflammatory disease (PID) can lead to complications such as infertility and ectopic pregnancy, it is not a contraindication for the use of oral contraceptives. In fact, oral contraceptives can provide some protection against PID by causing changes in the cervix that make it more resistant to infection.

Choice C rationale

A 32-year-old client who has benign breast disease. Benign breast disease is not a contraindication for the use of oral contraceptives. While some studies have suggested a slightly increased risk of breast cancer in women who have used oral contraceptives, the risk appears to decrease over time once the contraceptives are stopped.

Choice D rationale

A 26-year-old client who has migraine headaches at the start of each menstrual cycle. While migraines can be a contraindication for the use of oral contraceptives, it generally applies to migraines with aura. Women who have migraines with aura have an increased risk of stroke when using oral contraceptives. However, for women who have migraines without aura, the benefits of using oral contraceptives usually outweigh the risks.

Choice A rationale

Vitamin E is an important nutrient during pregnancy as it acts as an antioxidant, helping to protect cells from damage. However, its requirements do not decline during pregnancy due to an increase in body fat.

Choice B rationale

While iron is an important nutrient during pregnancy, it’s not necessary to double your intake. Iron needs do increase during pregnancy because it’s needed to make more blood to supply oxygen to the baby. However, this should be managed under the guidance of a healthcare provider.

Choice C rationale

While it’s true that calcium intake should be increased during breastfeeding, this is not specifically related to nutrition during pregnancy. During pregnancy, adequate calcium intake is important for the development of the baby’s bones and teeth.

Choice D rationale

Prenatal vitamins are designed to meet the increased nutritional needs of pregnancy, and they include a variety of vitamins and minerals. One of these is vitamin D, which helps the body absorb calcium and is important for the baby’s bone growth. Therefore, taking prenatal vitamins can indeed help to meet the need for increased vitamin D during pregnancy.