Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. The nurse or midwife should refer a client to a registered dietitian for in-depth nutritional counseling when the following exist(s)? Choose all that apply.

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The nurse should be especially aware that conditions such as diabetes can require in-depth dietary planning and evaluation. To prevent issues with hypoglycemia and hyperglycemia and an increased risk for perinatal morbidity and mortality,this client would benefit from a referral to a dietitian. Consultation with a dietitian may ensure that cultural food beliefs are congruent with modern knowledge of fetal development and that adjustments can be made to ensure that all nutritional needs will be met. The obese pregnant client may be under the misapprehension that because of her excess weight that little or no weight gain is necessary. According to the Institute of Medicine,a client with a body mass index in the obese range should gain at least 7 kg to ensure a healthy outcome. This client may well require in-depth counseling on optimum food choices. The vegetarian client needs to have her dietary intake carefully assessed to ensure that the optimum combination of amino acids and protein intake is achieved. Very strict vegetarians (vegans) who consume only plant products may also require vitamin B and mineral supplementation.

Most Women with Uncomplicated Pregnancies Can Use the Nurse as Their