A nurse is reviewing the laboratory results of a client who is at 32 weeks of gestation and has preeclampsia. The nurse should identify that which of the following findings is indicated with HELLP syndrome?

Bilirubin 1 mg/dL (0.1 to 1 mg/dL)

Uric acid 6.8 mg/dL (2 to 6.6 mg/dL)

Fibrinogen 500 mg/dL (200 to 400 mg/dL)

Aspartate aminotransferase 80 units/L (4 to 20 units/L)

Answer and Explanation

The Correct Answer is D

A. Bilirubin 1 mg/dL (0.1 to 1 mg/dL):

Bilirubin levels can be elevated in conditions involving liver dysfunction or hemolysis, such as HELLP syndrome. However, a bilirubin level of 1 mg/dL falls within the normal range (0.1 to 1 mg/dL). While bilirubin levels may be elevated in some cases of HELLP syndrome, this particular value is not indicative of HELLP syndrome.

B. Uric acid 6.8 mg/dL (2 to 6.6 mg/dL):

Elevated uric acid levels are commonly seen in preeclampsia, but they are not specific to HELLP syndrome. Uric acid levels can rise due to decreased renal function and increased cell breakdown. However, while a level of 6.8 mg/dL is slightly elevated compared to the normal range (2 to 6.6 mg/dL), it alone does not confirm the presence of HELLP syndrome.

C. Fibrinogen 500 mg/dL (200 to 400 mg/dL):

Fibrinogen levels are typically increased in pregnancy, but they can be decreased in conditions associated with consumption coagulopathy, such as disseminated intravascular coagulation (DIC). However, elevated fibrinogen levels are not typically associated with HELLP syndrome. A level of 500 mg/dL is above the normal range (200 to 400 mg/dL), but this finding alone does not indicate HELLP syndrome.

D. Aspartate aminotransferase (AST) 80 units/L (4 to 20 units/L):

Aspartate aminotransferase (AST) is a liver enzyme that can be elevated in liver injury or dysfunction, which can occur in HELLP syndrome. An AST level of 80 units/L is significantly elevated compared to the normal range (4 to 20 units/L), suggesting liver dysfunction. Elevated liver enzymes are a characteristic feature of HELLP syndrome, making this finding the most indicative of HELLP syndrome among the options provided.

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Correct Answer is B

Explanation

A. "I should avoid breastfeeding for 2 weeks following the immunization."

This statement is incorrect. There is no need to avoid breastfeeding after receiving the rubella vaccine. Breastfeeding is safe and not contraindicated following immunization with the rubella vaccine. Breastfeeding can continue as usual without interruption.

B. "I should avoid becoming pregnant for at least 1 month following the immunization."

This statement is correct. Following administration of the rubella vaccine, it is recommended to avoid becoming pregnant for at least 1 month. This precaution is due to theoretical concerns about the vaccine potentially affecting the developing fetus if a woman were to become pregnant shortly after vaccination. Rubella infection during pregnancy can cause serious birth defects, so it's important to take precautions to avoid potential harm to the fetus.

C. "I will report joint pain that develops after the immunization to my provider immediately."

While joint pain can be a rare side effect of the rubella vaccine, it is not typically necessary to report it immediately unless it is severe or persistent. Mild joint pain is a common and expected side effect of some vaccines, including the rubella vaccine, and typically resolves on its own without intervention. However, if joint pain is severe or persistent, it may be appropriate to report it to a healthcare provider for further evaluation and management.

A. The client cleans the perineum with a squeeze bottle after urinating. B. The client's perineal suture line is well-approximated. C. The client is changing the perineal pad once daily. D. The client is using witch hazel pads on the perineum.

Correct Answer is C

Explanation

A. The client cleans the perineum with a squeeze bottle after urinating:

This action is a recommended postpartum hygiene practice. Using a squeeze bottle filled with warm water to gently clean the perineum after urinating helps to promote cleanliness and prevent infection. It is important to maintain good hygiene in the perineal area to support wound healing and reduce the risk of complications.

B. The client's perineal suture line is well-approximated:

A well-approximated perineal suture line indicates that the edges of the laceration have been properly aligned and closed with sutures. This is an essential aspect of wound management, as it promotes healing by primary intention. When the wound edges are closely aligned and secured, it reduces the risk of infection and supports optimal healing.

C. The client is changing the perineal pad once daily:

Changing the perineal pad only once daily is a suboptimal practice that can contribute to delayed wound healing. Postpartum clients with perineal lacerations should change their perineal pads frequently, at least every 4 to 6 hours, to maintain cleanliness and prevent excessive moisture buildup, which can increase the risk of infection and hinder wound healing.

D. The client is using witch hazel pads on the perineum:

Witch hazel pads are commonly used for comfort and to alleviate swelling and discomfort in the perineal area after childbirth. While witch hazel pads can provide symptomatic relief, they are not typically associated with delayed wound healing when used appropriately. However, it's essential to ensure that the perineal area remains clean and dry to promote optimal wound healing and prevent complications.

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A nurse is reviewing the laboratory results of a client who is at 32 weeks of gestation and has preeclampsia. The nurse should identify that which of the following findings is indicated with HELLP syndrome?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a postpartum client who has a prescription for a rubella immunization. Which of the following client statements Indicates understanding of the teaching?

Correct Answer is B

Explanation

A nurse is caring for a client who is postpartum and has a perineal laceration. Which of the following findings places the client at risk for delayed wound healing?

Correct Answer is C

Explanation

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