The nurse is assisting in the care of the client who is at 30 weeks of gestation. For each client finding, click to specify if the client is at risk for developing HELLP syndrome or preeclampsia. 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.

• Hemoglobin: Hemoglobin is within normal limits at 12.5 g/dL. HELLP syndrome involves hemolysis, which could lower hemoglobin, but in this case, there is no evidence of anemia yet. Preeclampsia may cause hemoconcentration, but the client’s hemoglobin is not abnormal. • Platelet count: The client’s platelet count is 98,000/mm³, below the normal range. Thrombocytopenia is a hallmark of HELLP syndrome and can also occur in severe preeclampsia. Low platelets increase bleeding risk and indicate systemic endothelial dysfunction. Monitoring platelet trends is critical for anticipating complications and guiding treatment. • Liver enzymes: AST and ALT are elevated (38 and 40 units/L), reflecting hepatocellular injury. Elevated liver enzymes are a defining component of HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) and are commonly seen in preeclampsia due to hepatic involvement. • Fibrinogen: Fibrinogen is elevated at 500 mg/dL. HELLP syndrome involves a hypercoagulable state with microangiopathic hemolysis and liver involvement, often causing changes in fibrinogen levels. Elevated fibrinogen supports the presence of HELLP syndrome.