What cardiovascular finding should the nurse assess further in a client at 20 weeks' gestation?

In the context of a client at 20 weeks' gestation, a decrease in pulse rate would be an unusual finding that warrants further assessment. During pregnancy, there is an expected increase in blood volume and cardiac output, which typically leads to an elevation in heart rate rather than a decrease. As the body adapts to support the growing fetus, the heart works harder, and the pulse rate usually rises or stays within a normal range.

A decrease in pulse rate could suggest potential complications or issues, such as bradycardia or other underlying cardiovascular concerns that might need to be evaluated and monitored closely. Ensuring that the mother's cardiovascular system is functioning optimally is essential for the health of both the mother and the developing fetus.

The other options reflect physiological changes that are either normal or expected during pregnancy. For instance, while blood pressure can fluctuate, a decrease alone doesn't automatically indicate a problem unless it's significant or associated with alarming symptoms. An increase in heart sounds and heightened red blood cell production are also typical findings as the body adapts to pregnancy demands. Thus, a decrease in pulse rate stands out as a finding that may require further investigation.