A nurse is caring for a female client, age 32, at 28 weeks of gestation, admitted to the antepartum unit with a diagnosis of HELLP syndrome. The nurse is assessing the client 15 minutes later. For each finding, click to specify whether the finding is unrelated to the diagnosis, an indication that the client’s condition is improving, or an indication that the client’s condition is worsening.

Moderate maternal bleeding: Worsening condition. HELLP syndrome involves platelet consumption and liver dysfunction that can cause coagulopathy and bleeding risk. New or increased bleeding signals disease progression and possible disseminated intravascular coagulation (DIC). Client reports ringing in ears: Worsening condition. Tinnitus can be a sign of hypertensive encephalopathy or central nervous system involvement from severe preeclampsia/HELLP, indicating neurological deterioration. BP 180/100 mm Hg: Worsening condition. A significant increase from baseline hypertension signals uncontrolled blood pressure and heightened risk for stroke, organ damage, and progression of HELLP. Client reports sharp, stabbing abdominal pain: Worsening condition. This could indicate hepatic hematoma or infarction, a serious complication of HELLP syndrome due to liver injury. FHR 80/min with absent variability: Worsening condition. Fetal bradycardia with absent variability indicates fetal distress, often from placental insufficiency related to maternal vascular compromise. PT 12 seconds: Indication of improving condition. Normal prothrombin time (PT range ~11-13.5 seconds) suggests stable coagulation status, indicating no worsening coagulopathy or bleeding tendency at this moment.