A nurse is assessing a client with pre-eclampsia who is receiving oxytocin for labor induction.
Which finding would alert the nurse to suspect that the client is developing HELLP syndrome?
Epigastric pain or right upper quadrant pain
Blurred vision or flashes of light
Decreased urinary output or oliguria
Hyperreflexia or clonus
The Correct Answer is A
This is because HELLP syndrome is a complication of pregnancy that affects the liver and blood clotting. It can cause liver damage, bleeding problems, and high blood pressure. Epigastric pain or right upper quadrant pain is a sign of liver injury or rupture.
Choice B is wrong because blurred vision or flashes of light are symptoms of preeclampsia, not HELLP syndrome.
Preeclampsia is a condition that causes high blood pressure and protein in the urine during pregnancy. It can lead to HELLP syndrome, but not all women with preeclampsia develop HELLP syndrome.
Choice C is wrong because decreased urinary output or oliguria are also symptoms of preeclampsia, not HELLP syndrome.
Oliguria means producing less than 400 mL of urine in 24 hours. It can indicate kidney damage or failure due to high blood pressure or proteinuria.
Choice D is wrong because hyperreflexia or clonus are also symptoms of preeclampsia, not HELLP syndrome.
Hyperreflexia means having exaggerated reflexes, while clonus means having involuntary muscle spasms.
They can indicate nervous system involvement or seizures due to high
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Correct Answer is B
Explanation
To lower blood pressure.Hydralazine is an antihypertensive drug that is used to treat severe hypertension in pre-eclampsia.It works by relaxing the blood vessels and reducing the resistance to blood flow.
This helps to lower the blood pressure and prevent complications such as stroke, kidney damage, or placental abruption.
Choice A is wrong because hydralazine does not prevent seizures.
Seizures are a symptom of eclampsia, a more severe form of pre-eclampsia.To prevent seizures, magnesium sulfate is usually given intravenously.
Choice C is wrong because hydralazine does not increase urine output.In fact, it may cause fluid retention and edema as a side effect.Diuretics are drugs that increase urine output, but they are not recommended for pre-eclampsia because they may worsen the condition by reducing blood volume and placental perfusion.
Choice D is wrong because hydralazine does not improve placental perfusion.
Placental perfusion is the blood flow to the placenta, which provides oxygen and nutrients to the fetus.
Placental perfusion may be impaired in pre-eclampsia due to abnormal development of the placental blood vessels.Hydralazine does not affect the placental blood vessels directly, but it may improve placental perfusion indirectly by lowering the maternal blood pressure and reducing the risk of abruption.
However, this is not the primary or expected outcome of hydralazine therapy.
Correct Answer is C
Explanation
Magnesium sulfate.Magnesium sulfate is thedrug of choiceto prevent and treat seizures in people with severe preeclampsia and eclampsia.It is an anticonvulsant medication that reduces the risk of eclampsia by 50%.
Choice A is wrong because hydralazine is a blood pressure medication that can lower blood pressure in people with preeclampsia or eclampsia, but it does not prevent seizures.
Choice B is wrong because nifedipine is another blood pressure medication that can lower blood pressure in people with preeclampsia or eclampsia, but it does not prevent seizures.
Choice D is wrong because diazepam is an anticonvulsant medication that was previously used to treat eclamptic seizures, but it has been replaced by magnesium sulfate as the preferred drug due to its better safety and efficacy.Diazepam can also cause sedation and respiratory depression in the mother and the fetus.
Normal ranges for blood pressure are below 140/90 mm Hg, for proteinuria are below 300 mg/24 hours, for platelet count are 150,000 to 450,000 per microliter, for liver enzymes are 7 to 56 units per liter for alanine aminotransferase (ALT) and 10 to 40 units per liter for aspartate aminotransferase (AST), and for magnesium levels are 1.5 to 2.5 mEq/L.
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