Renee is a 21-year-old African American woman in her 35th week of pregnancy. She is married and the mother of two young children. Her pre-pregnancy BMI was 18.1. She has gained 24 pounds since becoming pregnant, but at her most recent prenatal visit, she was found to have lost a pound over the past week. She says that her weight loss is due to “stress.” Renee says she enjoys eating canned spinach cooked in tomato sauce with chopped onions and craves “Napoleon” flavored ice cream. Her 24-hour recall is as follows:
Breakfast:
16 oz kiwi strawberry drink
Lunch:
16 oz lemonade
1½ baked chicken breast
3 cups canned spinach cooked in canned tomato sauce and onion
2 slices of carrot cake with cream cheese frosting
Snack:
8 oz whole milk
1 peanut butter and jelly sandwich
Dinner:
16 oz decaffeinated tea
5 oz beef and rice dinner
4 scoops Neapolitan-style ice cream
Snack:
24 oz water
1 buttermilk biscuit
1. Why can’t the nurse use Renee’s current weight to calculate a BMI for her?
2. Considering Renee’s pre-pregnancy BMI, what weight gain goals would you give Renee?
3. Plot Renee’s weight gain on the prenatal weight-gain grid (Figure E-1, Appendix E of your text). What is your assessment of her weight gain?
4. What other factor besides energy intake from foods could cause a pregnant woman to gain weight?
5. On reviewing her 24-hour dietary recall, what suggestions might you have for Renee about:
a. her food choice for breakfast?
b. her intake of fruits and vegetables?
c. her intake of concentrated sweets?
d. increasing her calcium intake?
