PREGNANCY PROJECT PART 1

I. Identifying data A. Name: Natalie B. Natalie is a graduate of Brigham Young University who is now teaching high school full time for Teachers of America in Lakevillage, Arkansas. She lives with her husband who works as a teacher as well. She has a very limited budget. Health history A. Age 26 B. First pregnancy C. Due May 2, 2013 D. She had no labs on hand or that she could find in her household. She did not remember having any alarming labs results. E. She frequently experiences fatigue. F. She does not use cigarettes, alcohol, or illegal drugs. G. She had no deficiencies she was aware of prior to pregnancy but in the first trimester she experienced iron deficiency. H. She took no supplements or medications prior to pregnancy but is now taking a DHA supplement, iron supplement, and a prenatal supplement. I. Prior to pregnancy Natalie ran 3 to 4 times a week for 45 minutes each run. Now she does a light walk or jog 2 to 3 times a week for about 30 minutes at most each walk or jog. J. She has no allergies that she is aware of. Nutritional assessment A. Forms are attached. B. Based on the 24 hour dietary recall Natalie consumes around 2000 calories a day but needs 2400 calories a day. She has under consumed potassium, iron, vitamin B6, vitamin D, folate, choline, and omega 3 fatty acids. Dietary analysis coordinates with previously experienced iron deficiency experienced in her first trimester. Natalie also appears to over consume fruit and under consume vegetables and grains. Fruit consumption was at 185% of recommended fruit intake. Vegetable intake was only C. She does not use any assistance programs at this point in time. D. Takes prenatal vitamin. E. The subject prepares her own food and snacks frequently between meals. Weight graphed A. Pre-pregnancy weight 112, current weight 128, pre-pregnancy BMI 18, Height 56. B. A graph is included on the following pages. C. She has gained 16 pounds by about week 24 when I interviewed her. This is a normal and healthy rate of weight gain according to her pre-pregnancy BMI. Nutritional care plan A. I would say that overall Natalie needs to eat more calories each day this can be accomplished by adding an extra snack between breakfast and lunch. One cup of sugar

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coated cereal, a cup of skim milk, and a small banana would be about 400 calories and would be an example of a large snack that could get Natalies calories consumed up to 2400 calories needed daily. Cereal would also be a good breakfast choice since it could boost her folate intake. I would also suggest that Natalie replace some of the fruit she eats with large portions of dark green or orange vegetables. This would increase her potassium intake. She could also increase her meat intake to increase her calories overall and increase her iron and vitamin B6. To increase iron she should also consider increasing consumption of fortified grains. B. I would tell the subject to eat when she is hungry and to eat well to keep up her healthy weight gain. I would advise her to consider varying her diet in the sense that she would eat more vegetables in the place of her high fruit intake exchanging a cup of fruit for a cup of dark colored vegetables. I would also encourage her to continue taking her prenatal vitamin-mineral supplement.