The nurse is continuing to assist with the care of the client. The nurse is reviewing the findings. For each finding click to specify if the finding is consistent with preeclampsia 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.

Preeclampsia and HELLP syndrome are hypertensive disorders of pregnancy that can present with elevated blood pressure and proteinuria; however, HELLP syndrome is a severe variant characterized by hemolysis, elevated liver enzymes, and low platelets. The client’s findings of severe hypertension, proteinuria, thrombocytopenia, and elevated liver enzymes suggest progression from preeclampsia toward HELLP syndrome. Accurate interpretation of laboratory and clinical findings is critical for preventing maternal and fetal complications. Rationale: • Platelet count: Thrombocytopenia can occur in severe preeclampsia due to endothelial damage and platelet consumption. In HELLP syndrome, low platelets are a defining feature because of microangiopathic hemolysis and platelet destruction. The client’s platelet count of 98,000/mm³ indicates significant platelet depletion. Therefore, this finding is consistent with both conditions, though more severe in HELLP. • Alanine aminotransferase (ALT): Elevated ALT reflects hepatic involvement due to endothelial dysfunction and liver cell injury. In severe preeclampsia, liver enzymes may begin to rise as organ involvement progresses. In HELLP syndrome, elevated liver enzymes are a hallmark of hepatocellular damage. The client’s ALT of 40 units/L is elevated, supporting both disease processes. • Blood pressure: Severe hypertension is a defining feature of preeclampsia and is required for diagnosis when accompanied by proteinuria or organ dysfunction. The client’s blood pressure readings (162/112 and 166/110 mm Hg) indicate severe preeclampsia. HELLP syndrome often occurs in the setting of preeclampsia, but blood pressure elevation alone is not specific to HELLP. Therefore, this finding is primarily associated with preeclampsia. • Hemoglobin: Elevated hemoglobin in pregnancy can be associated with hemoconcentration due to plasma volume loss, which is often seen in preeclampsia progressing to HELLP syndrome. However, in HELLP syndrome, hemolysis is a defining feature and can alter hemoglobin levels as red blood cells are destroyed. The abnormal hemoglobin level in this context supports hemolysis-related changes consistent with HELLP.