The nurse is observing the meal selections of a group of pregnant and postpartal patients. One meal consists of a cup of skim milk, soy burger on a bun, baked beans, 8 ounces of water, four carrot sticks, and a mixed fresh fruit cup

Question

For which patient is this meal the best choice?
1. 27-year-old primip, 8 weeks' gestation, Hgb 11.0
2. 30-year-old multip two days postpartum, bottle-feeding
3. 15-year-old primip, one day postpartum, breastfeeding
4. 20-year-old multip, 32 weeks' gestation, reports fatigue.

Answer 1

Correct Answer: 3
Rationale 1: This patient needs a high-iron diet. The meal described is high in calcium and protein, but low in iron.
Rationale 2: The meal described is high in calcium and protein. This meal would be more than adequate for a bottle-feeding patient, but it is better suited to a breastfeeding patient.
Rationale 3: This is the best patient for this meal. Because the patient is an adolescent, she needs a high-protein diet, and because she is breastfeeding, she needs a high-calcium diet. The meal described is high in calcium and protein: milk, soy, and beans all are sources of protein, while milk and soy are good sources of calcium.
Rationale 4: The high protein and calcium of the described meal are good during pregnancy, but the report of fatigue could indicate a low hemoglobin level that requires additional assessment prior to recommending a specific diet.