A nurse is reviewing the laboratory results for a client who is at 29 weeks of gestation and has a history of anemia.Which of the following results should the nurse identify and report as an indication of a prenatal complication?
BUN 25 mg/dL (10 to 20 mg/dL).
Hgb 10.2 mg/dL (11 to 16 mg/dL).
Fasting blood glucose 70 mg/dL (70 to 110 mg/dL).
Hct 32% (33 to 47%).
The Correct Answer is A
The correct answer is Choice A
Choice A rationale: Blood urea nitrogen (BUN) level of 25 mg/dL exceeds the normal range of 10 to 20 mg/dL and may indicate impaired renal function or dehydration. In pregnancy, elevated BUN is concerning because renal perfusion is typically increased, leading to lower BUN levels. A rise suggests possible renal compromise, which can affect fetal development and maternal health. It warrants provider notification to assess for underlying pathology such as preeclampsia or renal insufficiency.
Choice B rationale: Hemoglobin level of 10.2 mg/dL is slightly below the normal pregnancy range of 11 to 16 mg/dL, indicating mild anemia. However, in the context of pregnancy, especially with a known history of anemia, this value is not critically low. Iron supplementation and dietary adjustments are typically sufficient. It does not represent an acute complication unless accompanied by symptoms like fatigue, pallor, or tachycardia. Therefore, it does not require immediate provider notification.
Choice C rationale: Fasting blood glucose of 70 mg/dL is at the lower end of the normal range for pregnancy, which spans from 70 to 110 mg/dL. This value is physiologically acceptable and does not indicate hypoglycemia or gestational diabetes. During pregnancy, insulin sensitivity fluctuates, but a fasting glucose of 70 mg/dL is not pathologic. No intervention is needed unless symptomatic hypoglycemia occurs. Thus, this result is not indicative of a prenatal complication.
Choice D rationale: Hematocrit level of 32% is slightly below the normal pregnancy range of 33 to 47%, reflecting mild dilutional anemia due to plasma volume expansion. This is a common physiological adaptation in pregnancy and not necessarily pathologic. Unless accompanied by symptoms or a significant drop in hemoglobin, this value alone does not indicate a prenatal complication. Monitoring and nutritional support are appropriate, but urgent provider notification is not required.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C"]
Explanation
Choice A rationale
Delay in initiating breastfeeding can occur after a cesarean birth due to the effects of anesthesia, postoperative recovery, and the need for medical monitoring, which can delay the mother’s ability to start breastfeeding.
Choice B rationale
Routine use of intubation equipment is not standard practice during a cesarean birth. Intubation is typically reserved for patients who require general anesthesia or have complications that necessitate airway management.
Choice C rationale
The need for an indwelling urinary catheter is common during a cesarean birth. It helps to keep the bladder empty and out of the way during the procedure and is usually placed after anesthesia and removed shortly after the surgery.
Choice D rationale
Management of postpartum pain is an important topic to discuss with clients undergoing cesarean birth. Postoperative pain management may include medications and non-pharmacological methods to ensure comfort and aid in recovery.
Correct Answer is D
Explanation
Choice A rationale
Leukorrhea is a common and normal occurrence in pregnancy due to increased estrogen production and greater blood flow to the vaginal area. It is usually a thin, white discharge and not a cause for concern unless accompanied by itching, burning, or an unusual odor.
Choice B rationale
Excessive salivation, also known as ptyalism, can occur during pregnancy, particularly in the first trimester. It is linked to hormonal changes and is not typically harmful, though it may be uncomfortable for the patient.
Choice C rationale
Darkening of the skin on the face, known as melasma or chloasma, is common during pregnancy and is due to increased pigmentation from hormonal changes. It typically resolves postpartum and is not harmful.
Choice D rationale
Epigastric pain in a pregnant client at 33 weeks gestation can be a sign of preeclampsia, a serious condition characterized by high blood pressure and damage to other organs. It requires immediate medical attention to prevent complications for both the mother and baby.
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