Read the information about Laura in the overview.?reate a post that answer the following questions:1. After reading about Laura’s diet and lifestyle, share some of your concerns with your colleagues: list at least two specific aspects of her diet or lifestyle that are concerning and explain why these are not ideal.2. Use the textbook and lecture material to identify a nutrient that is particularly important during pregnancy and discuss its importance – what is the recommendation, what can happen if the amount consumed is incorrect, etc.3. Based on a casual examination of Laura’s diet (ie you do not have to do the tracked analysis to answer this question), do you think she is getting enough of the micronutrient you identified in question 2- why or why not??BackgroundYou work as a nutrition consultant with a group of midwives. Today you are meeting with Laura, a 34 year old woman who is 30 weeks pregnant. Laura has had one previous pregnancy that resulted in the birth of a 9.7 pound healthy baby, Sarah, who is now 16 months old. Laura is married, and her husband, David, is with her at this visit. David works full time as a Physician Assistant, but the practice that he works for has recently been purchased by a health plan and he is unsure about his job’s future right now. Laura works half time as a legal secretary.Laura and David carefully planned for their first pregnancy. They were married several years ago, but waited to have their first child until they were financially secure enough that Laura could work part time after the baby came. They both made a point of making healthy food choices and avoiding alcohol when they were trying to conceive their first child. They attended both a preconception health education class and a prepared childbirth class.Sarah proved to be a challenging baby. She is only now beginning to sleep through the night. She had “colic” symptoms until she was almost 6 months old. Laura and David felt strongly about breastfeeding, and had been to classes and read books about breastfeeding. However, they encountered some difficulties with breastfeeding for the first few weeks. These included sore nipples, a breast infection, and a perceived lack of an adequate milk supply. When Laura went back to work 3 months post partum Sarah eagerly took bottles of formula while her mother was at work. Despite Laura’s plan to maintain exclusive breastfeeding and pumping of breastmilk for several months, Sarah was soon just nursing a couple of times a day, and stopped nursing altogether 2 to 3 weeks after Laura discovered that she was pregnant again.Laura and David had wanted another child at some point, but this current pregnancy was not intended. Although they have accepted the pregnancy, they state that they have concerns about the effect that a new baby will have on Sarah, their marriage, and their finances.Laura and David have good health insurance coverage, but Laura has only been seen 4 times for prenatal care for this pregnancy.Anthropometric DataJust prior to this pregnancy, Laura was 175 pounds (lbs). She is 61 inches tall. She gained 55 lbs her first pregnancy, and lost 20 before becoming pregnant again. Today she is 200 lbs.Health HistoryLaura’s health history is unremarkable. Her blood pressure today is within normal limits. She denies use of drugs, tobacco.Laura states that she does not like to exercise. She joined a health club a few years ago, but stopped going after about 6 weeks because she felt out of place and she thought that it was boring. She started a walking program after her first pregnancy with another new mother from her mom’s group, but her friend moved away and Laura doesn’t like to walk alone.At the beginning of both of her pregnancies Laura experienced considerable nausea and occasional vomiting as well as overwhelming fatigue. Today Laura complains of the onset of several pregnancy discomforts that also bothered her toward the end of her first pregnancy. These include heartburn, intermittent diarrhea and constipation, fatigue, and edema in her ankles.SupplementsLaura is occasionally taking a standard prenatal vitamin and mineral supplement that contains 30 mg per day of elemental iron. She feels that this supplement has contributed to some of her pregnancy related discomforts. David has recently been to a continuing education conference on nutrition and reproductive health. There were several vendors of nutritional supplements who displayed products at the conference. He is asking your advice today about fish oil, zinc, and calcium supplements in pregnancy.Dietary IntakeBefore the visit you asked Laura to keep three day food records. She brings them with her today. (See second to last page of this document). She states that this pattern is typical for a weekday when she works mornings. Saturdays are variable depending on what errands need to be done, but usually one or two meals are at a fast food place. On Sundays Laura goes out with David and Sarah after church for a large breakfast at Denny’s (fried eggs, bacon, toast, hash browns) and then has a pizza meal in the evening.LAURA’S TRACKED DIET (3 DAYS):Day OneDay TwoDay ThreeBreakfast2 c. Coffee with creamBreakfast2 c. Coffee with creamBreakfast2 c. Coffee with creamBreak at WorkDonutDecaf Coffee with creamBreak at WorkDonutDecaf Coffee with creamBreak at WorkDonutDecaf Coffee with creamLunchTuna sandwich (water packed albacore tuna, mayo, pickle relish, white bread)12 oz unpasturized Whole milkPotato chips?sandwich leftover from Sarah’s lunchLunchTuna sandwich (water packed tuna, mayo, pickle relish, white bread)unpasteurized Whole Milk?c pretzels?sandwich leftover from SarahLunchTuna sandwich (water packedtuna, mayo, pickle relish, whitebread)1 c Apple slices12 oz unpasteurized Whole Milk?leftover sandwich from SarahSnack with Sarah10 Triscuit?rackers2 oz Cheddar Cheese slicesUnpasteurized Apple Juice – 12 ozSnack with Sarah10 Triscuit Crackers2 oz Cheddar Cheese slicesUnpasteurized Apple Juice – 12 ozSnack Sarah10 Triscuit Crackers2 oz Cheddar Cheese slicesUnpasteurized Apple Juice -12 ozDinner1/3 a large chicken and spinach Pagliachi Pizza12 oz beerDinner1 ?c. Spaghetti?c tomato sauce with ground beef1 ?c Salad with iceberg lettuce, carrots, and tomatoes2 Tbsp. Ranch Dressing2 thick slices buttered garlic bread12 oz whole unpasteurized milkDinner1 Ham and Cheese “Hot Pocket”?c Green Peas20 French Fries12 oz whole milk1c. Hagen Daas Ice Cream withDove Chocolate SaucePeppermint tea 12 ozPeppermint tea 12 ozPeppermint tea 12 ozScienceBiologyBIOLOGY 100
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