The nurse is caring for a client, which symptom indicates severity of pregnancy- induced hypertension and signs of HELLP syndrome?

Weight gain and shortness of breath

Epigastric pain and elevated liver enzymes

Edema of hands and feet of +2

Fatigue and headache

Answer and Explanation

The Correct Answer is B

A. Weight gain and shortness of breath are common symptoms of pre-eclampsia or hypertension, but they are not specific to HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets). Shortness of breath could be due to other conditions, such as pulmonary edema, but it does not directly indicate HELLP syndrome.

B. Epigastric pain and elevated liver enzymes is a classic symptom of HELLP syndrome, a severe form of pregnancy-induced hypertension (PIH). The epigastric pain is often related to liver distention due to the liver damage and elevated liver enzymes. This is a key indicator of HELLP syndrome, which can be life-threatening if not managed promptly.

C. Edema of hands and feet of +2 is a common finding in pregnancy-related hypertension or pre-eclampsia but is not specific to HELLP syndrome. Mild edema (such as +2) can occur in many pregnancies and does not necessarily indicate the severity of the condition.

D. Fatigue and headache are symptoms commonly seen in pre-eclampsia and may also occur in HELLP syndrome, but they are less specific compared to epigastric pain and elevated liver enzymes, which are hallmark signs of HELLP syndrome.

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Correct Answer is D

Explanation

A. "I need to call my doctor if my temperature increases." This is an appropriate and accurate statement. An elevated temperature could be a sign of infection, which is a risk for women with preterm prelabor rupture of membranes (PPROM). The woman should contact her healthcare provider if her temperature rises, as infection can lead to complications.

B. "I can shower, but I shouldn't take a tub bath." This is also correct. After PPROM, the woman is typically allowed to shower to maintain personal hygiene, but taking a tub bath can increase the risk of infection by allowing bacteria to enter the vagina.

C. "I need to keep a close eye on how active my baby is each day." This is a correct and helpful statement. Monitoring fetal movement is important for assessing the baby's well-being. Decreased fetal movement could indicate a potential problem, and the woman should contact her provider if she notices reduced activity.

D. "It's okay for my husband and me to have sexual intercourse." This statement indicates a need for additional teaching. Sexual intercourse is typically not recommended after PPROM because it could increase the risk of infection, especially if the membranes are ruptured. The woman should avoid sexual activity until advised otherwise by her healthcare provider.

A. Polyhydramnios B. Placenta previa C. Placental abruption D. Ruptured ectopic pregnancy

Correct Answer is B

Explanation

A. Polyhydramnios refers to an excessive amount of amniotic fluid and typically presents with maternal discomfort, dyspnea, and possibly preterm labor, but not with vaginal bleeding as a primary symptom.

B. Placenta previa is the most likely diagnosis based on the assessment findings. It typically presents with painless, bright red vaginal bleeding in the second or third trimester, a soft, nontender uterus, no contractions, and a normal fetal heart rate. The bleeding may start spontaneously and often recurs. This fits the client's clinical picture precisely.

C. Placental abruption usually involves painful vaginal bleeding, a firm or tender uterus, and may be associated with uterine contractions or abnormal fetal heart rate patterns. The absence of pain and uterine tenderness in this case makes placental abruption less likely.

D. Ruptured ectopic pregnancy would not be expected at 33 weeks’ gestation. Ectopic pregnancies typically present in the first trimester and are accompanied by severe abdominal pain, vaginal bleeding, and signs of hypovolemic shock if ruptured.

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The nurse is caring for a client, which symptom indicates severity of pregnancy- induced hypertension and signs of HELLP syndrome?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a pregnant woman with preterm prelabor rupture of membranes about caring for herself after she is discharged home (which is to occur later this day). Which statement by the woman indicates a need for additional teaching?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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