Prenatal Nutrition Course
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1 Arizona WIC Training Prenatal Nutrition Course Nutrition Educator Guidebook
2 Table of Contents Nutrition Educator Guidebook What Will You Learn? page 3 Instruction Level page 3 Items Needed for this Course page 3 Recommended Time page 3 Things to Remember page 4 Module 1: Introduction to Prenatal Nutrition page 5 Prenatal Nutrition Activity 1 page 6 Module 2: Changes to a Woman s Body page 7 Module 3: Medical Risks and Special Circumstances page 7 Prenatal Nutrition Activity 2 page 8 Prenatal Nutrition Activity 3 page 9 Prenatal Nutrition Activity 4 page 10 Post-test Completion page 11 Competency Achievement Checklist page 12 2
3 What Will You Learn? A balanced diet is a basic part of good health at all times in a person s life. During pregnancy, proper nutrition is even more important. Prenatal nutrition promotes the mother s well-being during pregnancy and helps ensure a healthy start for her new baby. You will be able to guide a counseling session with a pregnant WIC participant to help her make choices for achieving her goals. The Prenatal Nutrition LMS course consists of three Modules: Module 1: Introduction to Prenatal Nutrition Module 2: Changes to a Woman s Body Module 3: Medical Risks and Special Circumstances After completing the Prenatal Nutrition LMS course, you will be able to: Describe recommendations for physical activity during pregnancy. Describe known health risks for smoking, drinking alcohol, and consuming illegal drugs during pregnancy. Describe how folate, iron, and water can impact a woman s health during pregnancy. Understand how to prevent potential nutrition-related concerns during pregnancy, including listeriosis, toxoplasmosis, mercury poisoning, and lead poisoning. Understand why there are potential medical risks during pregnancy related to closely spaced pregnancies, pica, teen pregnancy, and pregnancy with multiples. Describe the State and Local Agency policy and procedure for handling domestic violence situations. In a case study format, assess prenatal weight gain, biochemical and clinical status, and dietary risks for a pregnant participant. Instruction Level Prerequisite for taking the Prenatal Nutrition course: Basic Nutrition Course Items Needed for this Course Pen or pencil Access to the Arizona WIC Policy and Procedure Manual, either a hard copy or on the website, To save paper, you do not need to make copies of or print the policies or procedures. Microsoft PowerPoint to play the Prenatal Nutrition Jeopardy game Prenatal Nutrition Jeopardy Game Host/Game Operator Manual Local Agency and/or AZ State policy and procedure for Domestic Violence (Activity 3) Prenatal Weight Gain Chart for Pre-Pregnancy BMI (Activity 4) THTM #12: Pregnant Belly Prenatal Weight Gain (Activity 4) THTM #38: Keep Him that Way with Iron (Activity 4) THTM #27: Sensible Weight Loss Postpartum Weight Management (Activity 4) Hemoglobin chart for cutoff values for hemoglobin levels (Activity 4) 3
4 Recommended Time Approximate time it takes to complete the Prenatal Nutrition LMS course: 2-4 hours Approximate time it takes to complete the face-to-face activities and discussion: 2-3 hours Things to Remember This guidebook is yours to keep. Feel free to take notes, highlight, or write in the guidebook. Ask your trainer(s) if you need help, have questions about the information in the prenatal nutrition course, or have questions about additional topics related to prenatal nutrition. Your trainer will be assessing your understanding of the prenatal nutrition information throughout the duration of the course training. The training activities consist of WIC relevant topics and require critical thinking skills to complete. Participation in the face-to-face activities and discussions is expected and essential to successfully complete the prenatal nutrition course. Please see the Competency Achievement Checklist at the end of this guidebook. 4
5 Module 1: Introduction to Prenatal Nutrition Begin the LMS Prenatal Nutrition Course. Please complete the steps in the following order: Log onto Complete the Prenatal Nutrition Pre-Test. Open the Prenatal Nutrition Online Course. Optional: open the Prenatal Nutrition Course Companion Manual to reference throughout the course. Locate the Course Companion Manual by clicking on the Resources button within the LMS course. Complete Module 1: Introduction to Prenatal Nutrition Complete Prenatal Nutrition Activity 1, either individually, with the other nutrition educator(s), or with your trainer. Meet with your trainer to discuss the Introduction to Prenatal Nutrition Module and complete the Think It Through section for activity 1. 5
6 Prenatal Nutrition Activity 1 Mock Scenario: You are certifying a pregnant participant who is 15 weeks gestation. You ask her about activities she has been doing while pregnant and she tells you she walks and rides her horse. Think It Through: a. What are the American Congress of Obstetricians and Gynecologists recommendations for daily exercise? (Module 1, Slide 5) b. What does the American Congress of Obstetricians and Gynecologists recommend as examples of appropriate types of exercises while pregnant? (Module 1, Slide 5) c. How do you respond to the participant about the exercise she currently does? (Module 1, Slide 5) Hint: If needed, each activity identifies a specific slide(s) in the course in which you can find the information necessary to complete the activity. 6
7 Module 2: Changes to a Woman s Body Return to the LMS Prenatal Nutrition Course. Please complete the steps in the following order: If necessary, log back onto If necessary, re-open the Prenatal Nutrition Online Course. Complete Module 2: Changes to a Woman s Body Module 3: Medical Risks and Special Circumstances Continue the LMS Prenatal Nutrition Course. Please complete the steps in the following order: Complete Module 3: Medical Risks and Special Circumstances Complete Prenatal Nutrition activities 2, 3, and 4, either individually, with the other nutrition educator(s), or with your trainer. Meet with your trainer to discuss Module 2 and 3 and discuss activities 2, 3, and 4. 7
8 Prenatal Nutrition Activity 2 Prenatal Nutrition Jeopardy Game Instructions: Open the Prenatal Nutrition Jeopardy game on the Arizona WIC Local Agency Resource website. Your trainer has the Host/Game Operator Manual. The game requires Microsoft PowerPoint to function. This game may be played in many ways: 1) The nutrition educator plays the game alone; 2) The nutrition educator plays the game with the trainer; 3) The nutrition educator plays the game with the trainer and other nutrition educators in training; 4) The nutrition educator plays the game with the trainer and other WIC employees who are available. Think It Through: a. Describe known risks for consuming illegal drugs during pregnancy. (Module 1, Slide 10) b. What are ways to avoid contracting the parasite that causes toxoplasmosis? (Module 1, Slide 16) c. Why is Mercury harmful to the unborn fetus? (Module 1, Slide 17) d. What are common lead sources? (Module 1, Slide 13) e. What is pica? (Module 3, Slide 6) f. If a pregnant woman has pica, what is the treatment? (Module 3, Slide 6) g. Give three examples of pregnancy-related concerns with a greater impact during the teenage years. (Module 3, Slide 8) h. Why do women with closely spaced pregnancies have added risks? (Module 3, Slide 5) 8
9 Prenatal Nutrition Activity 3 Instructions: Discuss WIC s role in handling domestic violence situations. Think It Through: a. What domestic violence resources are available for WIC participants (ie: shelters, safe homes, counseling services, domestic violence advocacy organizations, hotline number, etc.)? b. What is your Local Agency s policy and procedure for domestic violence? c. The safety of the participant must be the first priority. What are suggestions of what to say or ask if the participant informs you she is in an abusive situation? (Module 3, Slide 13) d. What are some possible responses when a participant informs you she is in an abusive situation yet declines referral information? 9
10 Prenatal Nutrition Activity 4 Mock Scenario: A pregnant woman, Andrea, comes into your WIC clinic for her health check appointment. You find out the following information about her: Age: 30 years old Height: 5 6 Pre-pregnancy weight: 175 pounds Pre-pregnancy BMI: 28.2 Weight at 8 weeks gestation: 177 pounds Weight at 20 weeks gestation: 189 pounds Weight at 28 weeks gestation: 198 pounds Current weight: 198 pounds She is 28 weeks pregnant today Hgb: 10.1 g/dl, non-smoker Andrea tells you: Does not eat vegetables Eats out 5x/week, and typically orders fried foods Drinks 1 cup milk/day and no other dairy products Assessment: a. Andrea s pre-pregnancy BMI is considered: underweight, normal, overweight, or obese (Module 2, slide 3, click on link in chart) b. Amount of weight gain thus far during this pregnancy? c. What are her anthropometric risks? (Module 2, slide 3, click on link in chart; prenatal weight gain chart) d. What are her biochemical risks? (AZ WIC Laboratory Procedure Manual) e. What potential maternal complications is Andrea at an increased risk for if she gains too much weight during this pregnancy? f. What are referrals you can provide to Andrea? g. What are Andrea s dietary risks? 10
11 Prenatal Nutrition Activity 4, continued h. After conducting a thorough assessment on Andrea, what are six suitable nutrition education topics you can offer Andrea to choose from as a focus of her appointment? i. Which Touching Hearts Touching Minds (THTM) handouts contain pregnancy-related messages you can offer to discuss with Andrea? 11
12 Prenatal q Nutrition Post-Test Completion Return to the LMS Prenatal Nutrition Course Log onto Complete the Prenatal Nutrition Post-Test. Share the results of your Post-test with your trainer. 12
13 Competency Achievement Checklist / Prenatal Nutrition Curriculum Nutrition Educator s Name Local Agency Trainer: Evaluate the nutrition educator s competency of the prenatal nutrition information upon completion of the LMS course, along with all learning activities, and all discussion. Competency Achievement Checklist Prenatal Nutrition Curriculum At this checkpoint: Evaluate this: Competency Achievement Date: LMS Pre-test Nutrition educator completed the LMS Pre-test. Learning Activities Competencies LMS Post-test Nutrition educator accurately completed all activities specified for this course. All activities were discussed with the nutrition educator and reviewed for accuracy. Nutrition educator is able to describe recommendations for physical activity during pregnancy. Nutrition educator is able to describe known health risks for smoking, drinking alcohol, and consuming illegal drugs during pregnancy. Nutrition educator is able to describe how folate, iron, and water can impact a woman s health during pregnancy. Nutrition educator is able to recognize and discuss potential nutrition-related conditions during pregnancy, which include listeriosis, toxoplasmosis, mercury poisoning, and lead poisoning. Nutrition educator is able to recognize and discuss potential medical risks related to pregnancy, which include closely spaced pregnancies, pica, depression, teen pregnancy, and pregnancy with multiples. Nutrition educator is able to describe the State and Local Agency policy and procedure for handling domestic violence situations. In a case study format, nutrition educator is able to successfully assess prenatal weight gain, biochemical and clinical status, and dietary risks for a pregnant participant. Nutrition educator has achieved a score of 80% or better. Initials 13
14 I verify has achieved the learning objectives of the Online Prenatal Nutrition Course and is competent to continue with WIC training. The nutrition educator meets the criteria set by the State to receive a Certificate of Completion for this course. Trainer(s) Signature Date *File this signed competency achievement checklist in the appropriate employee training file, in accordance with WIC policy. 14
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