: Melissa has been referred to a registered dietitian for assistance with gaining weight. She is in her 25th week of pregnancy and although she

: Melissa has been referred to a registered dietitian for assistance with gaining weight. She is in her 25th week of pregnancy and although she had been experiencing nausea with vomiting beginning early in her pregnancy. She was able to attend her first appoint with her Obstetric and Gynecologist at the 24 week of her pregnancy and was diagnosed with hyperemesis gravidarum. The OBGYN was very concerned that she has only gained seven pounds thus far in her pregnancy Prior to becoming pregnant, her weight was 132lbs and she is 5’9″. Melissa tells you she has been following the dietary advice for nausea provided in a popular pregnancy magazine. These include 1 C of Ginger tea, Chamomile, lemon balm and raspberry leaf tea and lastly 25mg of Vitamin B6. Melissa became frustrated because after trying these suggestions as nothing seem to be working to quell her nausea and vomiting. When the doctor inquired about her dietary habits because of her low weight gain, Melissa became concerned that she is not consuming adequate nutrition for her and her baby. As the nutritionist, she asks you to evaluate her diet and if she should be taking any nutrition supplements besides the Vitamin B6. She stopped taking her prenatal vitamins last week to see if this might decrease her nausea because she remembered reading something about that as she researched cures for nausea and vomiting. A 24-hour food recall shows the following: 3 ounces grains, no vegetables, 1 cups fruits, 2 cups milk, 3 ounces of meat, and 1-2 teaspoons of fat. Must Show all Work to receive Credit Must Cite sources where appropriate Questions: 1. Approximately how much weight should Melissa have gained by now? a. Does this recommendation change in light of her diagnosis of hyperemesis gravidarum? 2. After speaking to Melissa regarding her current dietary habits and efforts to reduce her nausea and vomiting, what evidenced-based recommendations do you have for her? 3. Provide an evidenced-based explanation to melissa’s question regarding her dietary assessment a. Is it ethical to recommended nutrition supplements for Melissa? Explain.
4. Create a pregnancy appropriate meal plan for Melissa. a. Explain how you determined adequate calorie and nutrient needs for Melissa Nane Pre-pregnancy Normal Weight Range Prenatal Weight Gain God? 16 2010 Weight Categories for Women According to Height and Pre-pregnancy Weight (lbs): Hoght NO Dver Ooon WM Wed Weight BM GM 155 85 299) 249 4 < 60102 CH 3. 111 112 to 19 0 86 115 116 138136 < 15110 1-123 >10 103 134181 6 56122 189 150 ST 123 1 01 101. BE 17.00 69 101 141.00 10-145 146-1741 174 111 11.16 150 1791 179 <115 115.54 155 86 > 16 ST 19 118.68 169191 5 2841685 196 59 05.09 206 20 129 1973 4208 206 SIF <3 19214214 e 137.801942200 GT <10 106 HO 1994 1923328 <10 1.5-56200229 30 BM-Wege os X700 20 24 24 Weight Gain (Pounds) TE 16 14 Recommended Weight Gain Mark One: Single Underweight 21-40 NA Noma 25-35 37-54.06 Overweight 15-25 31-500 O 11-20 10 C . 4 Pre-pregnancy Weight Height 2 4 flow.2009 w Gan During pregnancy the Quees Wagon DC National Academies Pre per Person Communication in the Committee to IOM Pregnancy Weight Games 2 10 12 14 16 20 22 24 28 30 32 3442 Weeks in Gestation GOPRO