護理師正在對一名懷孕 10 週的婦女進行營養衛教。下列哪項陳述顯示該婦女需要進一步的指導？
A nurse is providing teaching to a client at 10 weeks of gestation about nutrition. Which statement by the client indicates a need for further instruction?
- AI should avoid eating unpasteurized cheeses like brie or feta.我應該避免食用布里乳酪或菲達乳酪等未經消毒的乳酪。
- BI should take a prenatal vitamin containing 400 to 800 mcg of folic acid daily.我應該每天服用含有 400 至 800 mcg 葉酸的孕期維生素。
- CI need to limit my caffeine intake to less than 200 mg per day.我需要將咖啡因攝取量限制在每天 200 毫克以下。
- DI will need to increase my caloric intake by 340 calories per day starting now.✓ 正解我現在起每天需要增加 340 卡路里的熱量攝取。
懷孕初期的營養需求與中後期不同。正確答案是 D，因為第一孕期（前三個月）並不需要額外增加熱量，維持懷孕前的攝取量即可；到了第二孕期才需增加約 340 kcal/day，第三孕期增加約 450 kcal/day。核心概念是避免過度體重增加導致妊娠糖尿病。選項 B 是正確的，葉酸對預防神經管缺陷至關重要。選項 A 正確，避免李斯特菌感染是孕期安全重點。選項 C 正確，過量咖啡因與流產風險相關，應限制在 200 mg 以內。護理師應針對孕期階段提供精確的熱量指導，而非一懷孕就大補特補。
Nutritional needs in early pregnancy differ from those in the second and third trimesters. The correct answer is D, because the first trimester does not require an additional caloric intake; maintaining pre-pregnancy intake is sufficient. By the second trimester, intake should increase by about 340 kcal/day, and by the third trimester by about 450 kcal/day. The core concept is to avoid excessive weight gain that could lead to gestational diabetes. Option B is correct: folic acid is critical to prevent neural tube defects. Option A is correct: avoiding Listeria infection is a safety priority during pregnancy. Option C is correct: excessive caffeine is associated with risk of miscarriage and should be limited to within 200 mg. The nurse should provide caloric guidance precise to the stage of pregnancy, rather than aggressively increasing intake as soon as pregnancy is confirmed.
美國衛教非常強調預防李斯特菌（Listeria），會明確列出軟乳酪清單；台灣則較強調避免生食（如生魚片）及中藥補品的使用禁忌，對於乳酪的具體衛教較少見。