At 37 years of age, Señora Mendez was in her 23rd week ofpregnancy and expecting her second child. Or so she thought untilan ultrasound scan detected twins. Her prepregnancy weight was 142pounds (64.5 kg) and her BMI 23 kg/m2. Señora Mendez’s weight-gain progress has been poor due to nausea and vomiting experiencedin the first half of pregnancy. Otherwise, Sra. Mendez wasexperiencing a normal pregnancy for women expecting twins. Concernsabout her weight-gain progress and the nutritional needs of womenwith twin gestation prompted her certified–nurse-midwife toprescribe a prenatal vitamin and mineral supplement and to referher to a registered dietitian/certified diabetes educator. Anutritional assessment completed during week 25 of pregnancyidentified that Sra. Mendez had gained 14 pounds since conception,and that her typical dietary intake excluded food sources of EPAand DHA. Her plasma 25-hydroxyvitamin D level was below 24 nmol/L,indicating low vitamin D status. No other nutrition-relatedproblems were identified.
Questions
1. Assume Sra. Mendez will deliver toward the end of week 37 andis now in the beginning of week 25. How many pounds (or kilograms)should be set as a goal for weekly weight gain if a total pregnancygain at the midpoint of the provisionally recommended range forweight gain in twin pregnancy is to be achieved?
2. State three appropriate nutrition diagnoses for thiscase.
3. Name one potential nutrition intervention that would addresseach of the nutrition diagnoses stated.
4. Cite a nutrition-related indicator that could be used tomonitor and evaluate each of the nutrition interventionsstated.
