A nurse in a prenatal clinic is caring for a client who is suspected of having a hydatidiform mole. Which of the following findings should the nurse expect to observe in this client?

Choice A reason: Disseminated intravascular coagulation (DIC) syndrome is not the correct answer, as it is a coagulation disorder that causes widespread clotting and bleeding in the body. DIC can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. DIC would cause a low platelet count, but also a prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), and a low fibrinogen level.

Choice B reason: Eclampsia is not the correct answer, as it is a seizure disorder that occurs in clients with severe preeclampsia. Eclampsia can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. Eclampsia would cause a high blood pressure, but also a proteinuria, edema, and hyperreflexia.

Choice C reason: Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome is the correct answer, as it is a variant of severe preeclampsia that affects the blood and the liver. HELLP syndrome is indicated by the laboratory results, as it causes a low platelet count, an elevated AST level, and a falling hematocrit. HELLP syndrome would also cause a high blood pressure, a proteinuria, and a right upper quadrant pain.

Choice D reason: Idiopathic thrombocytopenia is not the correct answer, as it is an autoimmune disorder that causes the destruction of platelets by antibodies. Idiopathic thrombocytopenia can affect pregnant women, but it is not related to severe preeclampsia or the laboratory results. Idiopathic thrombocytopenia would cause a low platelet count, but not an elevated AST level or a falling hematocrit.

Choice A reason: She is exhibiting hypertonic uterine dysfunction, because she has frequent and painful contractions that are ineffective in dilating the cervix. Hypertonic uterine dysfunction occurs when the uterus contracts too often and too forcefully, resulting in poor oxygenation and fetal distress. The woman may need tocolytic therapy, pain relief, and hydration.

Choice B reason: She is not experiencing a normal latent stage, because her contractions are too frequent and too painful for this phase of labor. The normal latent stage is characterized by irregular and mild contractions that gradually increase in frequency and intensity, and cervical dilation from 0 to 3 cm.

Choice C reason: She is not experiencing precipitous labor, because her labor is not progressing rapidly. Precipitous labor is defined as labor that lasts less than 3 hours from the onset of contractions to the delivery of the baby. It is associated with cervical dilation of more than 5 cm per hour.

Choice D reason: She is not exhibiting hypotonic uterine dysfunction, because her contractions are not weak or infrequent. Hypotonic uterine dysfunction occurs when the uterus contracts too weakly or too rarely, resulting in prolonged labor and increased risk of infection. The woman may need oxytocin augmentation, amniotomy, or cesarean section.