A nurse is reviewing the laboratory results of a client with HELLP syndrome.

Which of the following findings would indicate hemolysis?

Protein excretion of 450 mg indicates proteinuria.Proteinuria is the presence of excess protein in the urine, which can be a sign of kidney damage or disease.Normal protein excretion in a 24-hour urine collection is less than 150 mg.

Choice A is wrong because protein excretion of 150 mg is within the normal range.

Choice B is wrong because protein excretion of 250 mg is slightly above the normal range, but not enough to indicate proteinuria.

Choice C is wrong because protein excretion of 350 mg is also above the normal range, but not enough to indicate proteinuria.

Preeclampsia is a condition that affects some pregnant women, usually after 20 weeks of pregnancy.It causes high blood pressure and proteinuria, which can harm both the mother and the baby.A 24-hour urine collection is a simple lab test that measures what’s in the urine and checks kidney function.The test is done by collecting all the urine passed in a 24-hour period in a special container that must be kept cool until returned to the lab.

The correct answer is choice A, B, C and E.The nurse should monitor the client’s deep tendon reflexes hourly because magnesium sulfate can cause neuromuscular blockade and decreased reflexes.The nurse should keep calcium gluconate readily available because it is the antidote for magnesium toxicity.The nurse should maintain a urine output of at least 40 mL/hr because magnesium is excreted by the kidneys and low urine output can indicate renal impairment or fluid overload.The nurse should check the client’s blood pressure every 15 minutes because magnesium sulfate can cause hypotension and preeclampsia can cause hypertension.

Choice D is wrong because the medication should not be infused via a peripheral IV line, but rather through a central line or a large-bore IV catheter to prevent tissue damage.