A nurse is reviewing the laboratory results of a client who is at 32 weeks of gestation and has preeclampsia. The nurse should identify that which of the following findings is indicated with HELLP syndrome?
Bilirubin 1 mg/dL (0.1 to 1 mg/dL)
Uric acid 6.8 mg/dL (2 to 6.6 mg/dL)
Fibrinogen 500 mg/dL (200 to 400 mg/dL)
Aspartate aminotransferase 80 units/L (4 to 20 units/L)
The Correct Answer is D
A. Bilirubin 1 mg/dL (0.1 to 1 mg/dL):
Bilirubin levels can be elevated in conditions involving liver dysfunction or hemolysis, such as HELLP syndrome. However, a bilirubin level of 1 mg/dL falls within the normal range (0.1 to 1 mg/dL). While bilirubin levels may be elevated in some cases of HELLP syndrome, this particular value is not indicative of HELLP syndrome.
B. Uric acid 6.8 mg/dL (2 to 6.6 mg/dL):
Elevated uric acid levels are commonly seen in preeclampsia, but they are not specific to HELLP syndrome. Uric acid levels can rise due to decreased renal function and increased cell breakdown. However, while a level of 6.8 mg/dL is slightly elevated compared to the normal range (2 to 6.6 mg/dL), it alone does not confirm the presence of HELLP syndrome.
C. Fibrinogen 500 mg/dL (200 to 400 mg/dL):
Fibrinogen levels are typically increased in pregnancy, but they can be decreased in conditions associated with consumption coagulopathy, such as disseminated intravascular coagulation (DIC). However, elevated fibrinogen levels are not typically associated with HELLP syndrome. A level of 500 mg/dL is above the normal range (200 to 400 mg/dL), but this finding alone does not indicate HELLP syndrome.
D. Aspartate aminotransferase (AST) 80 units/L (4 to 20 units/L):
Aspartate aminotransferase (AST) is a liver enzyme that can be elevated in liver injury or dysfunction, which can occur in HELLP syndrome. An AST level of 80 units/L is significantly elevated compared to the normal range (4 to 20 units/L), suggesting liver dysfunction. Elevated liver enzymes are a characteristic feature of HELLP syndrome, making this finding the most indicative of HELLP syndrome among the options provided.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Human papillomavirus (HPV) vaccine:
The HPV vaccine is not recommended during pregnancy because there is limited safety data regarding its use in pregnant women. It is typically administered to individuals before they become sexually active to prevent HPV infections, which can lead to cervical cancer and other HPV-related diseases. Since the client is currently pregnant, administering the HPV vaccine would not be appropriate due to the lack of safety data during pregnancy.
B. Rubella vaccine:
The rubella vaccine is a live attenuated vaccine, and its administration during pregnancy is contraindicated due to the risk of congenital rubella syndrome (CRS) if the vaccine were to cause rubella infection in the pregnant woman. Rubella vaccination should be provided to non-pregnant individuals, particularly women of childbearing age, to prevent CRS. Administering the rubella vaccine to a pregnant woman at 28 weeks of gestation would pose a risk to both the mother and the developing fetus.
C. Varicella vaccine:
Similar to the rubella vaccine, the varicella (chickenpox) vaccine is a live attenuated vaccine and is contraindicated during pregnancy due to the risk of varicella infection in the pregnant woman, which can lead to severe complications for both the mother and the fetus. Varicella vaccination is recommended for individuals who have not had chickenpox or received the vaccine previously but should not be administered to pregnant women.
D. Tetanus vaccine:
Tetanus vaccination during pregnancy is recommended to prevent maternal and neonatal tetanus. Tetanus toxoid is considered safe during pregnancy and is routinely administered as part of the tetanus-diphtheria-pertussis (Tdap) vaccine. The tetanus vaccine helps protect against tetanus, a potentially fatal bacterial infection. Administering the tetanus vaccine during pregnancy is important for the health and safety of both the mother and the developing fetus.
Correct Answer is C
Explanation
A. IM in right deltoid:
The deltoid muscle is not typically used for IM injections in newborns. Additionally, the vastus lateralis muscle in the thigh is preferred over the deltoid muscle for IM injections in infants.
B. Subcutaneous in the right deltoid:
Subcutaneous administration is not the preferred route for phytonadione in newborns. Additionally, the deltoid muscle is not commonly used for subcutaneous injections in newborns.
C. IM in left vastus lateralis:
This is the correct choice. The vastus lateralis muscle in the thigh is the preferred site for IM injections in newborns due to its size and accessibility. Administering phytonadione via IM injection in the vastus lateralis muscle allows for optimal absorption of the medication.
D. Subcutaneous in the left vastus lateralis:
Subcutaneous administration is not the preferred route for phytonadione in newborns. Additionally, the vastus lateralis muscle is typically used for IM injections rather than subcutaneous injections in infants.
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