Miami Dade College, Miami

NUR 1142

MATERNITY
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The nurse reviews laboratory test results for a pregnant client at 32 weeks gestation. What
is the nurse's best action based on these results? Click on the exhibit button for additional
information.
Laboratory results
Hemoglobin 11.4 g/dL (114 g/L)

1. Complete the client assessment and documentation [56%]
2. Draw another sample for repeat complete blood count [7%]
3. Prepare for transfusion of packed red blood cells [9%]
4. Request a prescription for iron supplementation [26%]
EXPLANATION:
Pregnant women experience a 40%-45% increase in total blood volume during pregnancy
to meet the increased oxygen demand and nutritional needs of the growing fetus and
maternal tissues. Because the increase in plasma volume is greater than the increase in red
blood cells, a hemodiluted state called physiologic anemia of pregnancy occurs, and is
reflected in lower hemoglobin and hematocrit values. It is also normal for the white blood
cell count to increase during pregnancy; counts can be as high as 15,000/mm3 (15.0 x
109/L).
These laboratory results are within the normal ranges for a pregnant client in the third
trimester, and no intervention is required (Options 1 and 2).
(Option 3) A blood transfusion should not be considered in pregnancy unless severe
anemia (hemoglobin <7.0 g/dL [<70 g/L]) is suspected.
(Option 4) Iron is frequently prescribed for pregnant women to prevent o