A pregnant client, at 16 weeks' gestation, has a hematocrit of 34%. Her pre-pregnancy hematocrit was 40%. Which of the following statements by the nurse best explains this change?
Because of your pregnancy, you're not making enough red blood cells.
You're not eating enough iron-rich foods like meat.
This change may indicate a serious problem that might harm your baby.
Because your blood plasma volume has increased, your hematocrit count is lower.
The Correct Answer is D
Choice A rationale
During pregnancy, the body’s production of red blood cells usually increases to meet the increased demands of the growing fetus. Therefore, a drop in hematocrit is not typically due to insufficient red blood cell production.
Choice B rationale
While iron is essential during pregnancy, a reduction in hematocrit levels at 16 weeks' gestation is primarily due to increased plasma volume, rather than iron deficiency. Nutritional counseling may still be beneficial but isn't the primary explanation for this change.
Choice C rationale
A hematocrit level of 34% at 16 weeks is generally not considered indicative of a severe problem. Instead, it is a physiological response to increased plasma volume, known as dilutional anemia of pregnancy.
Choice D rationale
The primary reason for a lower hematocrit count during pregnancy is the increase in blood plasma volume, leading to dilutional anemia. This is a normal adaptation to pregnancy that ensures adequate blood flow to the fetus.
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Related Questions
Correct Answer is A
Explanation
Choice A rationale
Iron needs significantly increase during pregnancy to support the increased blood volume, the formation of the placenta, and the growth of the fetus. Pregnant women often require additional iron to prevent anemia and ensure adequate oxygen transport to the baby.
Choice B rationale
While calcium requirements do increase during breastfeeding to support milk production, this statement is not directly related to the nutritional needs during pregnancy. The focus during pregnancy should be on adequate intake of nutrients that support both maternal and fetal health.
Choice C rationale
Vitamin E requirements do not decline during pregnancy. In fact, the need for antioxidants like vitamin E may increase to protect both the mother and developing fetus from oxidative stress.
Choice D rationale
While prenatal vitamins are important for meeting various nutritional needs during pregnancy, they do not always provide sufficient vitamin D. Some women may need additional supplementation based on their dietary intake, sun exposure, and individual health needs.
Correct Answer is A
Explanation
Choice A rationale
Increasing folic acid intake immediately is recommended because it helps prevent neural tube defects, which can occur very early in pregnancy, often before a woman knows she is pregnant.
Choice B rationale
Starting folic acid intake one week before her period is not sufficient. Folic acid needs to be taken consistently before conception and during early pregnancy to be effective.
Choice C rationale
Waiting until pregnancy is confirmed may be too late to prevent neural tube defects, which form in the early weeks of pregnancy.
Choice D rationale
If she misses her period, it might already be too late to prevent neural tube defects. Consistent intake of folic acid before and during early pregnancy is essential.
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