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
At 9 weeks gestation, the primary purpose of an ultrasound is to confirm the presence of a fetal heartbeat, which indicates a viable pregnancy.
Choice B rationale
Chromosomal defects are typically assessed using different tests, such as chorionic villus sampling or amniocentesis, rather than an ultrasound at this early stage.
Choice C rationale
Fetal lung maturity cannot be assessed at 9 weeks gestation because the lungs are not yet developed. This assessment is usually done later in pregnancy if preterm delivery is anticipated.
Choice D rationale
The position of the fetus in utero is not a concern at this early stage of pregnancy. Fetal positioning becomes relevant later in pregnancy, closer to delivery.
Correct Answer is B
Explanation
Choice A rationale
A possible sign of pregnancy includes symptoms that are suggestive but not definitive, such as amenorrhea (absence of menstruation) or fatigue. These signs can have multiple causes and are not conclusive proof of pregnancy.
Choice B rationale
A positive sign of pregnancy includes objective evidence like fetal movement felt by the examiner, fetal heart sounds detected, or visualization of the fetus on ultrasound. These signs provide direct confirmation of pregnancy.
Choice C rationale
Presumptive signs of pregnancy are subjective experiences reported by the patient, such as nausea, breast tenderness, or quickening (feeling fetal movement). These signs are not confirmatory as they can occur in other conditions.
Choice D rationale
Probable signs of pregnancy include objective findings observed by a healthcare provider, such as uterine enlargement, but they are not definitive as they can also be caused by conditions like fibroids.
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