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.
Explanation & Rationale
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.