A nurse is admitting a client who has a history of atrial fibrillation. Which of the following conditions should the nurse recognize atrial fibrillation places the client at risk for?

Rationale:

• Platelet count: A drop in platelet count occurs in both preeclampsia and HELLP syndrome because of vascular endothelial damage leading to platelet aggregation and consumption. In HELLP, thrombocytopenia is often more severe, typically <100,000/mm³.

• Alanine aminotransferase (ALT): Elevated ALT reflects hepatocellular injury. It is a hallmark of HELLP syndrome (the “EL” = Elevated Liver enzymes) due to hepatic ischemia and microvascular damage, whereas in preeclampsia it may remain normal or only mildly elevated.

• Blood pressure: Hypertension (≥140/90 mm Hg) is the defining feature of preeclampsia and is also commonly seen in HELLP syndrome, which usually evolves from severe preeclampsia.

• Hemoglobin: Hemolysis (“H” in HELLP) results in decreased hemoglobin levels. In preeclampsia, hemoglobin levels are typically normal unless there is concurrent hemoconcentration or progression to HELLP syndrome.

Rationale:
A. Approach the client from the side: Approaching from the side can startle or confuse a client with vision loss. It is safer to approach the client from the front while clearly announcing your presence, allowing them to orient themselves.

B. Keep objects in the client's room in the same place: Maintaining consistent placement of personal items and furniture helps the client navigate safely and reduces the risk of falls. Predictable surroundings support independence and confidence in mobility.

C. Allow extra time for the client to perform tasks: Clients with vision impairment may need additional time to complete activities of daily living safely. Allowing extra time reduces stress, promotes autonomy, and ensures tasks are performed correctly without rushing.

D. Touching the client to announce presence is not recommended because it can startle them; verbal communication is preferred.

E. Ensuring proper, high-quality lighting in the room helps clients with low vision perform tasks more safely and accurately, improving overall safety and comfort.