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Chapter 71: Pregnancy and Lactation

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PM is a 28-year-old woman who comes to the pharmacy and states that her friend told her she needs to take vitamins before she becomes pregnant. She said she wants to try to become pregnant in a few months. She takes no medications, her vaccines are current and she consumes about 500 mg of caffeine per day.

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Which component of a multivitamin is associated with a decreased risk of neural tube defects?

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a. Calcium

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b. Iron

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c. Vitamin D

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d. Folic acid

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Answer d is correct. Adequate intake of folic acid decreases the incidence of neural tubal defects by 50% to 70%. Neural tube defects can occur in the first 4 weeks of development. It is important that all women of childbearing age take 400 mcg of folic acid daily. Some women with a higher risk of a pregnancy affected by neural tubal defects may require 4 mg daily.

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Answer a is incorrect: Calcium plays an important role in bone health. A fetus will require 30 grams of calcium for a full term pregnancy. Recommended daily calcium intake is 1300 mg for ages 14 to 18 years and 1000 mg for women 19 to 50 years.

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Answer b is incorrect: Iron is important to support the increase in red cell mass, expanded plasma volume and the growth of the fetal-placental unit. The CDC recommends 27 to 30 mg of elemental iron daily.

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Answer c is incorrect: Adequate vitamin D is important for maintaining the proper amount of calcium and phosphorus for healthy bones and teeth.

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PM is a 28-year-old woman who comes to the pharmacy and states that her friend told her she needs to take vitamins before she becomes pregnant. She said she wants to try to become pregnant in a few months. She takes no medications, her vaccines are current and she consumes about 500 mg of caffeine per day.

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If PM does become pregnant, which vaccines are safe to administer during pregnancy?

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a. Varicella and MMR

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b. Influenza and Tdap

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c. Tdap and HPV

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d. Influenza and MMR

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Answer b is correct: Influenza is associated with a high morbidity and mortality. The vaccine is available as inactivated virus and has no reports of harm to the fetus. The CDC recommends pregnant women receive the vaccine in any trimester. Tdap is recommended with each pregnancy and is safe to administer. During pregnancy ...

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