A nurse is caring for a client who has a diagnosis of HELLP syndrome.

The nurse should monitor the client for which of the following complications? (Select all that apply.)

Disseminated intravascular coagulation (DIC)

Acute kidney injury

Pulmonary edema

Placental abruption

Fetal growth restriction

Answer and Explanation

Correct Answer : A,C,D,E

The correct answer is choice A, C, D and E. Here is why:

• Choice A is correct because disseminated intravascular coagulation (DIC) is a blood clotting disorder that can develop as a complication of HELLP syndrome. DIC can result in excessive bleeding or blood clots in various organs.

• Choice B is wrong because acute kidney injury is not a common complication of HELLP syndrome. However, preeclampsia can cause kidney damage and proteinuria (high levels of protein in the urine).

• Choice C is correct because pulmonary edema is a condition where fluid accumulates in and around the lungs, impairing oxygen absorption. It can occur as a complication of HELLP syndrome due to high blood pressure and fluid overload.

• Choice D is correct because placental abruption is a condition where the placenta separates from the uterus before delivery.

It can cause severe bleeding and fetal distress. It can occur as a complication of HELLP syndrome due to high blood pressure and abnormal blood clotting.

• Choice E is correct because fetal growth restriction is a condition where the fetus does not grow as expected. It can occur as a complication of HELLP syndrome due to reduced blood flow and oxygen delivery to the placenta.

Normal ranges for liver enzymes are:

• Alanine aminotransferase (ALT): 7 to 55 units per liter (U/L)

• Aspartate aminotransferase (AST): 8 to 48 U/L

• Alkaline phosphatase (ALP): 45 to 115 U/L

Normal range for platelet count is:

• 150,000 to 450,000 platelets per microlitre.

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Correct Answer is A

Explanation

Headache that does not respond to analgesics.This is a possible sign of postpartum pre-eclampsia, a rare condition that occurs when a woman has high blood pressure and excess protein in her urine soon after childbirth.Postpartum pre-eclampsia can cause seizures and other serious complications if not treated.

Choice B is wrong because breast engorgement and tenderness are normal symptoms of breastfeeding and do not indicate postpartum pre-eclampsia.

Choice C is wrong because lochia rubra with small clots is a normal discharge of blood and tissue from the uterus after delivery and does not indicate postpartum pre-eclampsia.

Choice D is wrong because perineal pain and swelling are common after vaginal delivery and do not indicate postpartum pre-eclampsia.

Normal ranges for blood pressure are below 120/80 mm Hg and for protein in urine are below 150 mg/day.

A. Blood pressure of 150/90 mm Hg B. Urine protein of 2+ C. Epigastric pain D. Facial edema

Correct Answer is C

Explanation

This is a manifestation of severe preeclampsia that indicates liver involvement and can precede a seizure.

The nurse should report this finding to the provider immediately and prepare for possible delivery of the baby.

Choice A is wrong because blood pressure of 150/90 mm Hg is a sign of mild preeclampsia, not severe.Severe preeclampsia is diagnosed when the systolic pressure is 160 mm Hg or higher or the diastolic pressure is 110 mm Hg or higher.

Choice B is wrong because urine protein of 2+ is also a sign of mild preeclampsia, not severe.Severe preeclampsia is diagnosed when the urine protein is 3+ or higher.

Choice D is wrong because facial edema is a common finding in normal pregnancy and does not indicate severe preeclampsia.Other signs of severe preeclampsia include headache, blurred vision, oliguria, thrombocytopenia, and pulmonary edema.

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A nurse is caring for a client who has a diagnosis of HELLP syndrome. The nurse should monitor the client for which of the following complications? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge instructions to a client who had severe pre-eclampsia and delivered a healthy baby at 36 weeks of gestation. The nurse should instruct the client to report which symptom to the provider as a possible sign of postpartum pre-eclampsia?

Correct Answer is A

Explanation

A nurse is assessing a client who is 24 weeks pregnant and has preeclampsia. Which of the following findings should the nurse report to the provider as a manifestation of severe preeclampsia?

Correct Answer is C

Explanation

A nurse is reviewing the electronic health record of a client who has severe preeclampsia and is being induced with oxytocin. Which of the following findings should the nurse report to the provider immediately?

A nurse is evaluating the effectiveness of magnesium sulfate therapy for a client who has eclampsia. Which of the following outcomes indicates that the therapy is successful?

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A nurse is caring for a client who has a diagnosis of HELLP syndrome. The nurse should monitor the client for which of the following complications? (Select all that apply.)

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A nurse is teaching a pregnant client about the risk factors for pre-eclampsia. Which of the following should the nurse include? (Select all that apply).

A nurse is evaluating the effectiveness of magnesium sulfate therapy for a client with eclampsia. Which of the following findings indicates a therapeutic response?

A nurse is providing discharge teaching to a client who had HELLP syndrome and a cesarean birth. The nurse should instruct the client to report which of the following findings to the provider?

A nurse is caring for a client who has a diagnosis of HELLP syndrome.

The nurse should monitor the client for which of the following complications? (Select all that apply.)