A pregnant client at 22 weeks’ gestation has a hematocrit of 35%. Pre-pregnancy hematocrit was 40%. Which of the following statements by the nurse best explains this change?

Choice A rationale
Meconium is produced by the fetal intestines. The intestines start to form meconium around the 16th week of gestation. Meconium is composed of shed cells, mucus, amniotic fluid, bile, and lanugo.
Choice B rationale
The placenta does not produce meconium. Its primary functions include nutrient transfer, gas exchange, and waste elimination, but it does not have the structures necessary for the production of meconium.
Choice C rationale
Amniotic fluid does not produce meconium. Amniotic fluid surrounds and protects the fetus but does not contain the components needed to create meconium. Instead, the fetus swallows and then excretes it into the intestines.
Choice D rationale
Fetal kidneys are responsible for filtering waste and producing urine, but they do not produce meconium. The production of meconium is a function of the intestines, not the kidneys.

Choice A rationale
While iron-rich foods are important, the decrease in hematocrit is primarily due to hemodilution rather than inadequate iron intake. Hemodilution occurs as plasma volume increases more than red cell mass.
Choice B rationale
Hematocrit changes in pregnancy are typically not indicative of a serious problem but a normal physiological adaptation. Hemodilution reduces hematocrit without indicating a pathological condition.
Choice C rationale
During pregnancy, plasma volume increases by approximately 50%, while red cell mass increases by about 30%, leading to hemodilution. This physiological change results in a lower hematocrit value.
Choice D rationale
Although hematocrit decreases due to hemodilution, it does not mean that there is a deficiency in red blood cell production. It reflects the dilution effect of increased plasma volume during pregnancy.