The nurse at a gynecology clinic speaks with a 25-year-old, 32-week pregnant client. The nurse assesses the client and the client's laboratory results. Which of the following findings should most concern the nurse?
The nurse at a gynecology clinic speaks with a 25-year-old, 32-week pregnant client. The nurse assesses the client and the client's laboratory results. Which of the following findings should most concern the nurse?
A. Glucose present in the urine
[72%]
B. The client reports +1 pedal edema at the end of the day
[6%]
C. The client reports increased vaginal discharge
[19%]
D. A hemoglobin level of 14 g/dL [11.5 to 14 g/dL]
[2%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Antepartum
Client Need
Test Plan
Health Promotion and Maintenance
Related Topic
Ante/Intra/Postpartum and Newborn Care
Item Type
Item Type
Analysis
Explanation
Choice A is correct. Glucose in the urine may indicate gestational diabetes, as up to half of female clients have glucose in their urine at some time during pregnancy. Glucose in the urine may mean that a pregnant client has gestational diabetes. The nurse should promptly alert the health care provider (HCP) to allow further assessment into the cause of the glucose present in the client's urine.
Choice B is incorrect. As pregnancy progresses, clients will often report the presence of slight pedal edema. This pedal edema occurs due to the pressure of the growing fetus on the vena cava, thus reducing venous return from the lower extremities.
Choice C is incorrect. Increased vaginal discharge commonly occurs during pregnancy, especially as the client progresses toward the third trimester. As the client nears term, there is increased vascularity in the vagina and perineum. The nurse should inquire whether the discharge is foul-smelling, bloody, and/or abnormally colored, as these characteristics would be cause for concern and would need to be reported to the health care provider (HCP) for further evaluation.
Choice D is incorrect. A hemoglobin level of 14 g/dL is an acceptable level for a pregnant client. Normal hemoglobin levels in pregnant women range from 11.5 to 14 g/dL. During pregnancy, the amount of blood in the client's body increases by about 20-30%, increasing the supply of iron and vitamins needed to make hemoglobin. Factors such as dehydration and overhydration can affect the test results.
Learning Objective
When reviewing the assessment and laboratory findings of a 25-year-old, 32-week pregnant client, identify glucose in the client's urine as the most concerning finding.
Related Videos
3 Key Topics
Gestational Diabetes
28.5 Infection & Complication Risks
Additional Info
- During routine prenatal care, clients undergo testing for gestational diabetes between 24 and 28 weeks of pregnancy.
- Approximately 6-10% of women in the United States develop gestational diabetes.
- Testing for gestational diabetes initially includes a glucose challenge test. If the client's blood glucose level exceeds the acceptable test range during the glucose challenge test, the client will subsequently undergo follow-up glucose tolerance testing to confirm or rule out a gestational diabetes diagnosis.
