A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating

Choice A: Hemodilution of pregnancy is a normal physiological phenomenon that occurs when the plasma volume increases more than the red blood cell mass, resulting in a lower hemoglobin concentration. The normal hemoglobin range for pregnant women in the second trimester is 10.5 to 14 g/dL.

Choice B: A multiple gestation pregnancy may cause a higher hemoglobin level due to increased erythropoietin production by the placenta. The normal hemoglobin range for pregnant women with twins in the second trimester is 12 to 16 g/dL.

Choice C: Greater-than-expected weight gain is not related to hemoglobin level. Weight gain during pregnancy depends on various factors such as pre-pregnancy weight, nutrition, activity level, and fetal growth.

Choice D: Iron-deficiency anemia is a condition where the hemoglobin level is below the normal range due to inadequate iron intake or absorption, blood loss, or increased iron demand. The signs and symptoms of iron-deficiency anemia include fatigue, pallor, weakness, shortness of breath, and pica.

Choice A Reason: This is correct because this description accurately reflects one of the main functions of amniotic fluid, which is to act as a shock absorber and buffer against external forces or movements that could harm the fetus. Amniotic fluid also allows the fetus to move freely and develop its muscles and bones.

Choice B Reason: This is incorrect because this description is false. The amount of amniotic fluid changes throughout the pregnancy, depending on the stage of fetal development and other factors. The normal range of amniotic fluid volume is between 500 and 1000 mL at term. Too much or too little amniotic fluid can indicate a problem with the fetus or the placenta.

Choice C Reason: This is incorrect because this description is false. The fluid is not mostly protein, but mostly water (about 98%). The water comes from the mother's blood plasma and the fetal urine. The remaining 2% of amniotic fluid consists of various substances, such as electrolytes, hormones, enzymes, antibodies, and fetal cells. Amniotic fluid does not provide nourishment to the fetus, but rather protects it from infection and helps regulate its temperature.

Choice D Reason: This is incorrect because this description is false. Amniotic fluid does not act as a transport mechanism for oxygen and nutrients, but rather as a barrier that prevents them from reaching the fetus directly. Oxygen and nutrients are delivered to the fetus through the placenta and the umbilical cord, which are connected to the maternal blood circulation.