Review HELLP Syndrome

Pre-eclampsia, Eclampsia > Maternal & Newborn

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HELLP Syndrome

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Total Questions : 5

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Question 1:

A nurse is caring for a client with HELLP syndrome.

Which of the following laboratory tests should the nurse monitor closely?

A. Blood glucose B. Serum creatinine C. Coagulation profile D. Thyroid function

Answer and Explanation

Choice A:

Blood glucose is not directly affected by HELLP syndrome, although it may be elevated in women with gestational diabetes or pre-existing diabetes.

Choice B:

Serum creatinine is a marker of kidney function, not liver function.However, kidney function may also be impaired in women with preeclampsia or eclampsia, which are associated with HELLP syndrome.

Choice C:

This is because HELLP syndrome is a pregnancy complication that involveshemolysis(breaking down of red blood cells),elevated liver enzymes(indicating liver injury) andlow platelet count(impairing blood clotting).A coagulation profile can help monitor these abnormalities and assess the risk of bleeding or clotting complications.

Choice D:

Thyroid function is not related to HELLP syndrome.Thyroid disorders may occur in pregnancy, but they have different symptoms and causes.

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Question 2:

A client with HELLP syndrome reports severe epigastric pain and nausea.

The nurse should suspect that the client is experiencing:

A. Hepatic rupture B. Pancreatitis C. Gastric ulcer D. Cholecystitis

Answer and Explanation

Choice A:

The client with HELLP syndrome is experiencing severe epigastric pain and nausea due to liver damage caused by hemolysis, elevated liver enzymes and low platelets.Hepatic rupture is a life-threatening complication of HELLP syndrome that can cause bleeding and shock.

Normal ranges for liver enzymes are AST < 40 IU/L and ALT < 56 IU/L.Normal range for platelet count is 150-400 x 10⁹/L.

Choice B:

Pancreatitis is wrong because it is not a common complication of HELLP syndrome and it usually causes more diffuse abdominal pain rather than localized epigastric pain.

Choice C:

Gastric ulcer is wrong because it is not associated with HELLP syndrome and it does not explain the other symptoms such as hemolysis, elevated liver enzymes and low platelets.

Choice D:

Cholecystitis is wrong because it is not related to HELLP syndrome and it usually causes right upper quadrant pain rather than epigastric pain.

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Question 3:

A nurse is reviewing the discharge instructions for a client who had HELLP syndrome during pregnancy.

Which of the following statements by the client indicates a need for further teaching?

A. “I will need to have regular blood pressure checks for a few weeks.” B. “I will avoid taking any nonsteroidal anti-inflammatory drugs (NSAIDs).” C. “I will resume my oral contraceptive pills as soon as possible.” D. “I will report any signs of bleeding or infection to my provider.”

Answer and Explanation

Choice A:

This statement is correct because women who had HELLP syndrome are at risk of developing high blood pressure or preeclampsia after delivery and need to monitor their blood pressure regularly.

Choice B:

This statement is correct because NSAIDs can interfere with platelet function and increase the risk of bleeding, which can be harmful for women who had HELLP syndrome.

Choice C:

This statement indicates a need for further teaching because oral contraceptive pills are not recommended for women who had HELLP syndrome during pregnancy.Oral contraceptive pills can increase the risk of blood clots and high blood pressure, which can be dangerous for women with a history of HELLP syndrome.

Women who had HELLP syndrome should consult their provider about alternative methods of contraception that are safer for them.

Choice D:

This statement is correct because women who had HELLP syndrome are at risk of developing complications such as hemorrhage, infection, liver rupture, or stroke and need to seek medical attention if they notice any signs of bleeding or infection.

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Question 4:

A nurse is preparing to administer magnesium sulfate to a client with HELLP syndrome.

Which of the following actions should the nurse take? (Select all that apply.)

A. Monitor the client’s deep tendon reflexes B. Check the client’s urine output every hour C. Administer calcium gluconate as an antidote if needed D. Keep a bag of 0.9% sodium chloride solution at the bedside E. Flush the IV line with heparin before and after infusion

Answer and Explanation

Choice A:

Monitoring the client’s deep tendon reflexes is a way to assess the client’s neuromuscular status and the risk of magnesium toxicity. Magnesium sulfate can cause muscle weakness and decreased reflexes.

Choice B:

Checking the client’s urine output every hour is a way to monitor the client’s renal function and fluid balance. Magnesium sulfate is excreted by the kidneys and can cause oliguria and fluid overload.

Choice C:

Administering calcium gluconate as an antidote if needed is a way to treat magnesium toxicity. Calcium gluconate reverses the effects of magnesium sulfate on the neuromuscular and cardiovascular systems.

Choice D:

Keeping a bag of 0.9% sodium chloride solution at the bedside is a way to prepare for possible complications of magnesium sulfate therapy such as hypotension, pulmonary edema, or cardiac arrest. Normal saline can help restore blood pressure and fluid balance.

Choice E:

Flushing the IV line with heparin before and after infusion is not necessary or recommended for magnesium sulfate administration. Heparin is an anticoagulant that can increase the risk of bleeding and is not compatible with magnesium sulfate.

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Question 5:

A nurse is providing education to a pregnant client who is at risk for developing HELLP syndrome.

Which of the following information should the nurse include?

A. HELLP syndrome can occur before or after delivery B. HELLP syndrome is caused by a bacterial infection C. HELLP syndrome can be prevented by taking folic acid supplements D. HELLP syndrome is treated with corticosteroids and antihypertensives

Answer and Explanation

Choice A:

• HELLP syndrome is a rare pregnancy complication that is a type of preeclampsia.It stands for hemolysis (breaking down of red blood cells), elevated liver enzymes (indicating liver damage), and low platelet count (affecting blood clotting).

• HELLP syndrome usually occurs during the third trimester of pregnancy, but it can also develop in the first week after childbirth (postpartum preeclampsia).

• Normal ranges for some of the tests used to diagnose HELLP syndrome are:

➤ Lactate dehydrogenase (LDH): 140 to 280 U/L

➤ Aspartate transaminase (AST): 10 to 40 U/L

➤ Platelet count: 150 to 450 x 10^9/L

Choice B:

HELLP syndrome is not caused by a bacterial infection, but by unknown factors that may involve abnormal placental development.

Choice C:

HELLP syndrome cannot be prevented by taking folic acid supplements, but by early diagnosis and treatment of preeclampsia.

Choice D:

HELLP syndrome is treated with corticosteroids and antihypertensives, but only as supportive measures to manage the symptoms and complications.The definitive treatment is delivery of the baby as soon as possible.

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HELLP Syndrome

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