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A nurse is caring for a client who is pregnant.

Exhibits
The nurse is reviewing the client's assessment findings.

For each of the client's assessment finding. click to specify if the finding is consistent with preeclampsia with severe features or HELLP syndrome. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

A.

Hemoglobin

B.

Alanine aminotransferase (ALT)

C.

Platelet count

D.

Blood Pressure

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A,B"},"D":{"answers":"A,B"}}

Hemoglobin 18.0 g/dL

Preeclampsia: Mild hemoconcentration can occur due to third spacing and fluid shift.

HELLP Syndrome: HELLP is more characterized by low hemoglobin due to hemolysis rather than high hemoglobin.

Alanine aminotransferase (ALT) 40 units/L

Preeclampsia: Liver enzymes can be mildly elevated in severe preeclampsia, but not as prominent as in HELLP.

HELLP Syndrome: Consistent finding. Elevated ALT reflects liver dysfunction, one of the hallmark components of HELLP (Hemolysis, Elevated Liver enzymes, Low Platelets).

Platelet count 98,000/mm³

Preeclampsia: Thrombocytopenia can occur in severe preeclampsia. Platelets <100,000/mm³ is concerning for progression to severe disease.

HELLP Syndrome: Consistent finding. Low platelets are a key diagnostic criterion of HELLP syndrome.

Blood Pressure 162/112 mm Hg

Preeclampsia: Consistent finding. Hypertension (≥140/90 mm Hg) is the primary diagnostic criterion for preeclampsia.

HELLP Syndrome: Often present with elevated blood pressure as well. HELLP is a variant of severe preeclampsia so elevated BP is common.


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Related Questions

Correct Answer is D

Explanation

A. The supine position can reduce venous return and decrease cardiac output in pregnant clients; the left lateral position is preferred.

B. Methylergonovine is contraindicated in clients with hypertension or preeclampsia because it can cause severe vasoconstriction and increase blood pressure.

C. Dextrose IV bolus is used to treat hypoglycemia, not magnesium toxicity.

D. Calcium gluconate is the antidote for magnesium sulfate toxicity. It reverses respiratory depression, bradycardia, and cardiac conduction issues caused by excessive magnesium levels.

Correct Answer is D

Explanation

Rationale:

A. Hyperactive deep tendon reflexes are unrelated to opioid toxicity; they may occur in hypercalcemia or stimulant toxicity, not narcotic overdose.

B. Fluid retention is not characteristic of morphine toxicity; opioids primarily depress the central nervous system and respiration.

C. Prolonged QT interval is more often associated with medications such as methadone or certain antiarrhythmics, not morphine.

D. Bradypnea (slow respiratory rate) is the hallmark of morphine toxicity due to central nervous system and respiratory depression. Other signs include sedation, pinpoint pupils, and decreased level of consciousness. The nurse should immediately stop the infusion, monitor vital signs, and prepare to administer naloxone, an opioid antagonist, as prescribed.

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