A nurse is reviewing laboratory findings for a client who is at 20 weeks of gestation. Which of the following findings should the nurse report to the provider?

Choice A rationale A hematocrit of 37% falls within the normal physiological range for a pregnant individual, which typically expands due to increased plasma volume. This hemodilution is a normal adaptive response to pregnancy, ensuring adequate perfusion to the placenta and fetal unit. This finding does not warrant reporting as it reflects a healthy maternal circulatory adjustment. Choice B rationale A creatinine level of 0.9 mg/dL is within the normal reference range for renal function in pregnant individuals. Glomerular filtration rate (GFR) increases during pregnancy, leading to a slight decrease in serum creatinine. This value indicates appropriate renal clearance and is not a cause for concern. Choice C rationale A WBC count of 11,000/mm³ is generally considered within the physiological elevation often seen during pregnancy, particularly in the second and third trimesters. This mild leukocytosis is an immunological adaptation, supporting the maternal immune response without indicating an infectious process or pathology that requires immediate reporting. Choice D rationale A fasting blood glucose of 180 mg/dL is significantly elevated above the normal range (74 to 106 mg/dL) and indicates hyperglycemia. This finding is highly suggestive of gestational diabetes mellitus, which can lead to adverse maternal and fetal outcomes if not managed. Therefore, it requires immediate reporting to the provider for further evaluation and intervention.