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

Choice A reason: A WBC count of 11,000/mm3 is slightly elevated but normal in pregnancy due to physiological leukocytosis from increased immune activity. This supports maternal and fetal protection against infections. It does not indicate pathology requiring reporting, as it aligns with expected gestational changes in immune function, per hematological norms. Choice B reason: Hematocrit of 37% is within the normal pregnancy range (37-47%), reflecting hemodilution from increased plasma volume. This ensures adequate placental perfusion and oxygen delivery. It does not indicate anemia or other complications requiring reporting, as it aligns with physiological adaptations in pregnancy, per hematological reference ranges. Choice C reason: Creatinine of 0.9 mg/dL is normal (0.5-1 mg/dL) in pregnancy, reflecting increased glomerular filtration rate due to higher renal blood flow. This supports waste clearance for maternal and fetal health. It does not indicate renal dysfunction or require reporting, as it aligns with expected gestational renal physiology. Choice D reason: Fasting blood glucose of 180 mg/dL indicates gestational diabetes, as it exceeds the normal range (74-106 mg/dL). Elevated glucose crosses the placenta, risking fetal macrosomia, hypoglycemia, or congenital anomalies. This requires immediate reporting for management to prevent adverse perinatal outcomes, per endocrinological and obstetric guidelines.