A nurse is reviewing laboratory results for a client who is 24 weeks pregnant.
Which finding is expected based on normal renal adaptation during pregnancy?
A nurse is reviewing laboratory results for a client who is 24 weeks pregnant.
Which finding is expected based on normal renal adaptation during pregnancy?
A. Trace glucose in the urine
[21%]
B. Serum creatinine level of 1.1 mg/dL (97.2 µmol/L) [<0.8 mg/dL, <70.7 µmol/L]
[17%]
C. Negative protein and ketones in the urine
[49%]
D. Decreased glomerular filtration rate (GFR)
[12%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Newborn
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. Trace glucose in the urine can be a normal finding in pregnancy due to increased glomerular filtration rate (GFR) and reduced renal tubular reabsorption. It does not necessarily indicate gestational diabetes unless confirmed by other diagnostic testing.
Choice B is incorrect. A serum creatinine of 1.1 mg/dL (97.2 µmol/L) is elevated in pregnancy. Due to increased renal blood flow and GFR, serum creatinine normally decreases, typically to 0.4–0.8 mg/dL [35.4 µmol/L–70.7 µmol/L] during pregnancy.
Choice C is incorrect. While protein and ketones are ideally absent, small amounts of trace protein may appear due to increased renal workload. However, ketones may indicate inadequate caloric intake and require follow-up.
Choice D is incorrect. GFR actually increases by up to 50% during pregnancy to accommodate the increased metabolic and waste removal demands of both mother and fetus.
Learning Objective
Identify normal renal laboratory findings and adaptations that occur during pregnancy and differentiate them from pathological changes.
Related Videos
2 Key Topics
Renal Labs
2.2 Metabolic & Organ Function Panels
Additional Info
✓Pregnancy causes significant renal physiologic adaptations to support maternal and fetal metabolic needs.
✓Increased blood volume and cardiac output elevate renal perfusion and increase GFR, leading to lower serum BUN and creatinine.
✓The renal threshold for glucose is lowered, allowing for small amounts of glucose to appear in the urine.
✓Persistent or high-level glucosuria or proteinuria should be evaluated for gestational diabetes or preeclampsia, respectively.
✓Normal serum creatinine in pregnancy is lower than in the nonpregnant state; values >1.0 mg/dL 88.4 µmol/L may indicate renal impairment.
