What is the most likely explanation for W.H. developing gestational diabetes with this pregnancy, but not with her previous pregnancies?
Chapter 22W.H. is 22 weeks pregnant with her third baby. Her two other children are two and four years old and she gained 15 lbs with each pregnancy. Her previous pregnancies were uncomplicated, so she was surprised to hear that she has developed gestational diabetes. She has always enjoyed some extra desserts and snacks while she is pregnant, figuring she is eating for two. Plus, now that she has two small children, she reasons that she needs extra energy to take care of them too.1) What is the most likely explanation for W.H. developing gestational diabetes with this pregnancy, but not with her previous pregnancies?2) W.H. is going to meet with a registered dietitian. What general recommendations is she likely to make?Chapter 23Z.S. has chronic kidney disease treated using hemodialysis three times per week. She used to be slightly overweight, but in the past 2 years, since she started hemodialysis, she has gradually lost weight and is now close to her ideal body weight. She hasn’t had much appetite, so for the first time in her life, she found it easy to lose weight! She doesn’t want to lose any more weight, but she finds it hard to balance all the restrictions and plan meals. She is 55 years old, weighs 60 kg, and her urine output is 300 mL/day.3) Calculate Z.S. recommended intake for energy and protein.4) Z.S. is wondering if a vegetarian diet would be more healthy for her. How would you counsel her?
