A nurse is reviewing the medical record of a client who is at 37 weeks of gestation and has HELLP syndrome. Which of the following laboratory findings should the nurse expect?

BUN 20 mg/dL

Platelet count 77,000/mm3

Hemoglobin 12 g/dL

WBC count 18,000/mm3

Answer and Explanation

The Correct Answer is B

A. BUN 20 mg/dL: This is not specific to HELLP syndrome. A BUN level of 20 mg/dL is within the normal range and does not indicate the presence of HELLP syndrome, which is associated with liver dysfunction and low platelet count.

B. Platelet count 77,000/mm3: This is correct. HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets) is characterized by a low platelet count, often less than 100,000/mm3, which is a critical indicator of this condition.

C. Hemoglobin 12 g/dL: This is a normal hemoglobin level and is not typically associated with HELLP syndrome, where hemolysis (destruction of red blood cells) can cause anemia, which would lower hemoglobin levels.

D. WBC count 18,000/mm3: While an elevated WBC count can indicate infection or inflammation, it is not specifically associated with HELLP syndrome. The hallmark features of HELLP syndrome are low platelets and liver enzyme elevation, not elevated WBC.

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Correct Answer is B

Explanation

A. Preferred bath time is incorrect. While important for comfort and care planning, the preferred bath time is not critical information for change-of-shift report unless directly relevant to immediate care.

B. Time of last pain medication is correct. Information about the last dose of pain medication is essential to assess the client’s current pain level and determine if another dose is required. It also helps to plan for ongoing pain management and monitor for signs of over-medication or under-medication.

C. Steps required for dressing change is incorrect. While it is important to know the steps for dressing changes, this would typically be included in the written care instructions, not necessarily as part of the verbal change-of-shift report.

D. Admission vital signs is incorrect. Admission vital signs are not typically necessary for change-of-shift report unless there has been a significant change in the client’s condition since admission. It is more important to focus on current assessments and interventions.

A. Encourage the client to be assertive. B. Maintain a verbal no-harm contract with the client. C. Limit the client's social interactions. D. Assume responsibility for making the client's decisions.

Correct Answer is A

Explanation

A. Encourage the client to be assertive is correct. Encouraging assertiveness is important for a client with dependent personality disorder (DPD., as they often have difficulty making decisions or taking initiative. Teaching the client to express their needs, opinions, and desires is a key part of treatment and helps promote independence.

B. Maintain a verbal no-harm contract with the client is incorrect. While maintaining a no-harm contract may be appropriate for clients at risk for self-harm, this is not specific to dependent personality disorder. The main goal is to promote independence and healthy decision-making, not just ensuring safety.

C. Limit the client's social interactions is incorrect. In fact, encouraging healthy social interactions and gradual independence from others is often an important part of treatment for DPD. Limiting interactions could reinforce dependency and hinder progress.

D. Assume responsibility for making the client's decisions is incorrect. The nurse should encourage the client to make their own decisions and foster independence, rather than taking over their decisions, which could worsen the dependent behaviors.

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A nurse is reviewing the medical record of a client who is at 37 weeks of gestation and has HELLP syndrome. Which of the following laboratory findings should the nurse expect?

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