Maternity Nursing: Antepartum Q 22

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The nurse recognizes that an expected change in the hematologic system that occurs during the 2nd trimester of pregnancy is:

  

     A. A decrease in WBC’s

     B. Increase in hematocrit.

     C. An increase in blood volume.

     D. A decrease in sedimentation rate.

    

    

Correct Answer: C. An increase in blood volume.

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The blood volume increases by approximately 40-50% during pregnancy. The peak blood volume occurs between 30 and 34 weeks of gestation. The hematocrit decreases as a result of the increased blood volume.

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Option A: WBC count increases to 6 to 16 million/mL and can be as high as 20 million/mL during and shortly after labor.

Option B: In pregnancy, the RBC volume increases by 20% to 30%, while the plasma volume increases 45 to 55%. This disproportionate volume increase leads to dilutional anemia with decreased hematocrit.

Option D: Fibrinogen and factors VII – X levels increase, but the clotting and bleeding times remain unchanged. However, increased venous stasis and damaged vessel endothelium result in higher rates of thromboembolic events during pregnancy.

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