A nurse is providing teaching to the guardians of a child who has respiratory syncytial virus (RSV). Which of the following information should the nurse include?

Rationale for correct choices

• Blood pressure: The client’s blood pressure readings are consistently elevated (162/112 mm Hg and 166/110 mm Hg), which is a hallmark of preeclampsia. Hypertension arises from abnormal placental development leading to systemic vasoconstriction. Elevated blood pressure is a primary diagnostic criterion for preeclampsia and is more directly indicative of this condition than HELLP syndrome alone. HELLP may occur without hypertension.

• Hemoglobin: The client’s hemoglobin is mildly elevated at 18 g/dL with a hematocrit of 35%, suggesting hemoconcentration and potential microangiopathic hemolysis, a component of HELLP syndrome. While preeclampsia may cause mild hemoconcentration, hemolysis is a defining feature of HELLP. This reflects red blood cell destruction associated with this syndrome.

• Alanine aminotransferase (ALT): ALT is slightly elevated at 40 units/L, reflecting liver involvement. Liver enzyme elevation can occur in severe preeclampsia due to hepatic ischemia and in HELLP syndrome due to hepatocellular injury from hemolysis and microvascular obstruction. The finding supports involvement in both conditions.

• Platelet count: The platelet count is low at 98,000/mm³, which can result from platelet activation and consumption in both preeclampsia and HELLP syndrome. Thrombocytopenia is a hallmark of HELLP syndrome and may also develop in severe preeclampsia. This finding indicates increased risk for bleeding and warrants prompt intervention and monitoring.

A. "The item serving size is consistent from one manufacturer to the next.": Serving sizes can vary between different manufacturers and products. Clients should read the label carefully for the specific serving size of each item, as it is not standardized across brands.

B. “The daily values relate to a 1,500-calorie diet.": Daily values on nutrition labels are based on a 2,000-calorie diet, not 1,500 calories. Understanding this helps clients interpret percentages correctly in the context of their individual dietary needs.

C. "Food manufacturers provide nutrition information voluntarily.": Nutrition labeling is required by law for most packaged foods. It is not voluntary, and clients should understand that these labels are standardized and regulated.

D. "The ingredient with the greatest weight appears first.": Ingredients on nutrition labels are listed in descending order by weight. The first ingredient is present in the largest amount, which helps clients make informed choices about food composition.