A nurse is reviewing laboratory results for a client who has HELLP syndrome.

Which of the following findings should the nurse expect? (Select all that apply.)

The correct answer is choice D. Hemoglobin 6 g/dL, platelets 25,000/mm3, AST 120 U/L, ALT 100 U/L.

This is because HELLP syndrome is a pregnancy complication that causes hemolysis (breaking down of red blood cells), elevated liver enzymes (indicating liver injury), and low platelet count (impairing blood clotting).

Choice A is wrong because hemoglobin 12 g/dL, platelets 150,000/mm3, AST 20 U/L, ALT 18 U/L are all within normal ranges and do not indicate HELLP syndrome.

Choice B is wrong because hemoglobin 10 g/dL, platelets 100,000/mm3, AST 40 U/L, ALT 35 U/L are mildly abnormal and may suggest mild preeclampsia but not HELLP syndrome.

Choice C is wrong because hemoglobin 8 g/dL, platelets 50,000/mm3, AST 80 U/L, ALT 70 U/L are moderately abnormal and may suggest moderate preeclampsia or incomplete HELLP syndrome but not full HELLP syndrome.

Normal ranges for these laboratory tests are:

• Hemoglobin: 11.5 to 16.5 g/dL for women.

• Platelets: 150,000 to 450,000/mm3 for adults.

• AST: 10 to 40 U/L for adults.

• ALT: 7 to 56 U/L for adults.

The correct answer is choice B. The client’s urine output is at least 30 mL/hr.This indicates that the therapy is effective because magnesium sulfate can cause renal impairment and fluid retention, which can worsen the condition of preeclampsia.

A normal urine output is a sign that the kidneys are functioning well and that the fluid balance is maintained.

Choice A is wrong because the client’s blood pressure may not normalize even with magnesium sulfate therapy.

Magnesium sulfate is mainly used to prevent seizures, not to lower blood pressure.Other antihypertensive medications may be needed to control blood pressure in severe preeclampsia.

Choice C is wrong because the client’s deep tendon reflexes are expected to decrease with magnesium sulfate therapy, as it is a central nervous system depressant.

A normal reflex response is 2+, but a lower response (1+ or 0) may indicate magnesium toxicity, which can cause respiratory depression, cardiac arrest, and coma.

Choice D is wrong because the client’s respiratory rate should be monitored closely with magnesium sulfate therapy, as it can also cause respiratory depression.

A normal respiratory rate is 12 to 20 breaths per minute, but a lower rate (less than 12) may indicate magnesium toxicity, which requires immediate treatment with calcium gluconate.