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 B
Explanation
Choice A rationale
At 16 weeks, the fundal height is typically below the umbilicus. This location is more indicative of a fetus at around 20 weeks.
Choice B rationale
At 20 weeks, the fundal height is usually at the level of the umbilicus, indicating this is the correct gestational age.
Choice C rationale
At 24 weeks, the fundal height is usually above the umbilicus, suggesting a more advanced gestation than the picture indicates.
Choice D rationale
At 28 weeks, the fundal height is significantly above the umbilicus, making this option incorrect for the given scenario.
Correct Answer is C
Explanation
Choice A rationale
Avoiding foods with strong aromas can help reduce nausea, as certain smells can trigger the sensation. This strategy is usually effective because olfactory stimuli can have a significant impact on nausea and vomiting during pregnancy.
Choice B rationale
Eating crackers or plain toast in the morning can help manage nausea by stabilizing blood sugar levels before getting out of bed. This simple carbohydrate source can provide quick energy and prevent morning sickness.
Choice C rationale
Drinking a glass of orange juice before getting out of bed is not recommended, as the acidity of the juice can irritate the stomach lining and exacerbate nausea. It is better to have bland, non-acidic foods first.
Choice D rationale
Eating a high-carbohydrate snack before going to sleep can help maintain stable blood sugar levels overnight, potentially reducing morning nausea. Carbohydrates are effective in providing sustained energy and preventing dips in glucose that can trigger nausea.
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