NR 602 Midterm Study Guide 2026 with Practice Questions and Answers

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[Morgan] Hematological changes during pregnancy Women’s Health p777
○ During pregnancy, blood volume increases by 30% to 50%, or 1,100 to 1,600 mL and peaks at 30 to 34 weeks’
gestation. The increase in blood volume improves blood flow to the vital organs and protects against excessive
blood loss during birth. Fetal growth during pregnancy and newborn weight are correlated with the degree of
blood volume expansion.
○ Of the blood volume expansion occurring during pregnancy, 75% is considered to be plasma. There is also a
slight increase in red blood cell volume (RBC).
○ The blood volume changes result in hemodilution, which leads to a state of physiologic anemia during
pregnancy. As the RBC volume increases, iron demands also increase.
○ Leukocytosis occurs in pregnancy, with white blood cell counts increasing to as much as 14,000 to 17,000 cells
per mm3 of blood. Clotting factors increase as well, creating a risk for clotting events during pregnancy.
○ Systemic vascular resistance is reduced due to the effects of progesterone, prostaglandins, estrogen, and
prolactin. This lowered systemic vascular resistance, in combination with inferior vena cava compression, is
partly responsible for the dependent edema that occurs in pregnancy.
○ Epulis of pregnancy, or hypertrophy of the gums accompanied by bleeding, may also occur and is due to
decreased vascular resistance and increase in the growth of capillaries during pregnancy.

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