A nurse is caring for a client with HELLP syndrome.

Which of the following laboratory tests should the nurse monitor closely?

Coagulation profile.This is because HELLP syndrome is a pregnancy complication that involveshemolysis(breaking down of red blood cells),elevated liver enzymes(indicating liver injury) andlow platelet count(impairing blood clotting).A coagulation profile can help monitor these abnormalities and assess the risk of bleeding or clotting complications.

Choice A is wrong because blood glucose is not directly affected by HELLP syndrome, although it may be elevated in women with gestational diabetes or pre-existing diabetes.

Choice B is wrong because serum creatinine is a marker of kidney function, not liver function.However, kidney function may also be impaired in women with preeclampsia or eclampsia, which are associated with HELLP syndrome.

Choice D is wrong because thyroid function is not related to HELLP syndrome.Thyroid disorders may occur in pregnancy, but they have different symptoms and causes.

Hepatic rupture.The client with HELLP syndrome is experiencing severe epigastric pain and nausea due to liver damage caused by hemolysis, elevated liver enzymes and low platelets.Hepatic rupture is a life-threatening complication of HELLP syndrome that can cause bleeding and shock.

Choice B.Pancreatitis is wrong because it is not a common complication of HELLP syndrome and it usually causes more diffuse abdominal pain rather than localized epigastric pain.

Choice C.Gastric ulcer is wrong because it is not associated with HELLP syndrome and it does not explain the other symptoms such as hemolysis, elevated liver enzymes and low platelets.

Choice D.Cholecystitis is wrong because it is not related to HELLP syndrome and it usually causes right upper quadrant pain rather than epigastric pain.

Normal ranges for liver enzymes are AST < 40 IU/L and ALT < 56 IU/L.Normal range for platelet count is 150-400 x 10⁹/L.