3. A client, who is a 16-year-old primigravida and 34 weeks pregnant, is complaining of constantly feeling tired. Which assessment should lead a nurse to suspect that the client's blood volume has increased?
3. A client, who is a 16-year-old primigravida and 34 weeks pregnant, is complaining of constantly feeling tired. Which assessment should lead a nurse to suspect that the client's blood volume has increased?
Test-Taking Tip
Remember the association of increase/decrease: ↑ blood volume resulting in ↓ hemoglobin and ↓ hematocrit. Blood volume increase in pregnancy does not increase all the components equally; for example, hemoglobin and hematocrit decrease with increased blood volume.
Content Area: Maternity, Antepartum; Integrated Process: Nursing Process, Assessment; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/System Specific Assessments
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Answer 1 is incorrect because increased hemoglobin is indicative of dehydration or third spacing of fluid that is common in preeclampsia. Decreased hemoglobin is associated with increased blood volume. Answer 2 is incorrect because hypercalcemia is associated with dehydration, not increased blood volume. Answer 3 is correct because decreased hematocrit is an indicator of increased blood volume, which is normal in pregnancy and peaks between 32 and 34 weeks' gestation. Answer 4 is incorrect because hyperkalemia is associated with dehydration, not increased blood volume.
