The nurse is continuing to care for the client. Exhibits The nurse is reviewing the assessment findings. For each assessment finding, click to specify if the finding is consistent with preeclampsia or HELLP syndrome. Each finding may support more than one disease process.

Rationale: &bull; Platelet count: A drop in platelet count occurs in both preeclampsia and HELLP syndrome because of vascular endothelial damage leading to platelet aggregation and consumption. In HELLP, thrombocytopenia is often more severe, typically <100,000/mm&sup3;. &bull; Alanine aminotransferase (ALT): Elevated ALT reflects hepatocellular injury. It is a hallmark of HELLP syndrome (the “EL” = Elevated Liver enzymes) due to hepatic ischemia and microvascular damage, whereas in preeclampsia it may remain normal or only mildly elevated. &bull; Blood pressure: Hypertension (&ge;140/90 mm Hg) is the defining feature of preeclampsia and is also commonly seen in HELLP syndrome, which usually evolves from severe preeclampsia. &bull; Hemoglobin: Hemolysis (“H” in HELLP) results in decreased hemoglobin levels. In preeclampsia, hemoglobin levels are typically normal unless there is concurrent hemoconcentration or progression to HELLP syndrome.