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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 A

Explanation

Rationale:

A. A health care surrogate (also called a durable power of attorney for health care) is a person designated by the client to make health care decisions if the client becomes incapacitated. This is a key component of advance directives.

B. Advance directives can be revised or revoked by the client at any time as long as they remain competent to do so.

C. Legal counsel is not required to assign a surrogate, though the document typically needs to be witnessed and signed according to state regulations.

D. A DNR order is optional and separate from other parts of an advance directive; clients may choose to include or exclude it.

Correct Answer is D

Explanation

Rationale:

A. While long-term budgeting can aid financial planning, cost-effectiveness in healthcare focuses on strategies that balance quality and expense in the short to medium term. A 10-year budget does not inherently ensure cost-effective care.

B. Purchasing more expensive items does not guarantee better outcomes. Cost-effective care means achieving the best possible client outcomes at the lowest reasonable cost.

C. Hiring travel nurses generally increases staffing costs due to higher hourly wages and agency fees, making it a less cost-effective option unless used temporarily during staffing crises.

D. Preventing hospital readmissions through effective discharge planning, client education, and follow-up care reduces unnecessary healthcare utilization and expenses while improving patient outcomes. This is a key measure of both quality and cost-effective nursing practice.

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