19.15 Nutritional Support

Nutrition plays an important role in the care of high-risk perinatal clients and the developing fetus. High-risk perinatal conditions, such as gestational diabetes, preeclampsia, and other preexisting medical conditions, require individualized nutrition plans developed in collaboration with a registered dietician. These individualized nutrition plans take into account the specific medical condition and needs of the pregnant client, as well as their medical history, current health status, and dietary restrictions or preferences. Nutritional plans ensure the intake of adequate calories, protein, vitamins, and minerals to support the increased nutritional demands of pregnancy, as well as nutritionally manage the medical condition.

For example, clients with gestational or pregestational diabetes closely monitor blood glucose levels and receive health teaching about carbohydrate counting, portion control, and timing of meals with insulin therapy to prevent hypoglycemia. Complex carbohydrates, fiber-rich foods, lean proteins, and healthy fats are emphasized to help stabilize blood sugar levels. Clients diagnosed with preeclampsia or elevated blood pressure are encouraged to follow a low-sodium diet to help manage blood pressure levels.

As in all pregnancies, folic acid is recommended to prevent neural tube defects, iron-rich foods are recommended to prevent anemia, and sufficient calcium intake is recommended to support fetal bone development and maternal bone health. Prenatal vitamins are encouraged, and additional supplements may be prescribed, such as iron or vitamin D. Nurses monitor the client’s weight gain during prenatal visits, as well as their nutritional status to ensure appropriate weight gain during pregnancy while meeting nutritional goals.