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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is []
Explanation
Rationale for correct condition: Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy, leading to dehydration, weight loss, and electrolyte imbalance. The client's significant weight loss of 2.8 kg (6.2 lb) in two weeks, increased nausea and vomiting, and decreased appetite are classic symptoms. The elevated BUN level suggests dehydration, which aligns with hyperemesis gravidarum. The absence of abdominal pain and the presence of facial pallor further support this condition.
Rationale for actions:
- Initiate IV fluid therapy to rehydrate the client and correct electrolyte imbalances caused by excessive vomiting.
- Administer ondansetron IV to control nausea and vomiting, improving the client's ability to tolerate oral intake.
Rationale for parameters:
- Weight should be monitored to assess the effectiveness of interventions and ensure the client is regaining or maintaining a healthy weight.
- Urine output indicates hydration status and kidney function, helping to evaluate the adequacy of fluid replacement.
Rationale for incorrect conditions:
- Cholecystitis: The client denies abdominal or epigastric pain, which is a key symptom of cholecystitis.
- Gestational diabetes mellitus: There is no mention of elevated blood glucose levels or other diabetic symptoms.
- Preeclampsia: The client's blood pressure is within normal range, and there are no signs of hypertension or proteinuria.
Correct Answer is B
Explanation
Choice A rationale
Maintaining a folic acid intake of 4 mcg per day is not sufficient. The recommended dose for pregnant women is 400-800 mcg to help prevent neural tube defects, but it is not specifically related to reducing the risk of preterm labor.
Choice B rationale
Increasing fluid intake to 8-10 (8 oz) glasses per day is recommended as it helps to maintain hydration, which is crucial in preventing preterm labor. Dehydration can cause uterine contractions, which can lead to preterm labor.
Choice C rationale
Consuming the recommended daily allowance of vitamin C (85 mg) is important for immune function and overall health but does not directly affect the risk of preterm labor.
Choice D rationale
Increasing caloric intake by 500 calories per day is typically recommended for breastfeeding mothers, not for preventing preterm labor during pregnancy. Proper nutrition is important, but overconsumption can lead to excessive weight gain.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.