When caring for a client with pre-eclampsia, which laboratory result should the nurse report to the physician immediately?

Choice A rationale

A platelet count of 50,000/mm³ is critically low (normal range is 150,000-450,000/mm³) in a client with pre-eclampsia. Thrombocytopenia is a serious complication of pre-eclampsia and can significantly increase the risk of bleeding and hemorrhage. This finding requires immediate reporting and intervention.

Choice B rationale

A hemoglobin level of 11 grams/dL is within the lower end of the normal range for postpartum women (typically 12-15 g/dL) and is not an immediate concern in the context of pre-eclampsia, unless there is a rapid decline or other concerning symptoms.

Choice C rationale

A creatinine level of 0.3 mg/dL is below the normal range for non-pregnant adults (typically 0.6-1.2 mg/dL) and might be lower in pregnancy due to increased glomerular filtration rate. While kidney function should be monitored in pre-eclampsia, this specific value is not immediately alarming.

Choice D rationale

A fasting blood glucose of 65 mg/dL is within the normal range (typically 70-100 mg/dL) and is not a typical finding that requires immediate reporting in pre-eclampsia, although gestational diabetes can sometimes coexist.

Choice A rationale

Proteinuria, the presence of protein in the urine, is not a typical immediate complication following an amniocentesis. It is more commonly associated with preeclampsia, a condition of pregnancy. While the nurse would monitor the patient's overall condition, proteinuria is not a direct risk related to the amniocentesis procedure itself.

Choice B rationale

Hemorrhage is a potential complication following an amniocentesis. The procedure involves inserting a needle through the abdominal wall and uterus to withdraw amniotic fluid, which carries a risk of bleeding at the insertion site, within the uterus, or even fetomaternal hemorrhage (bleeding from the fetal circulation into the maternal circulation). The nurse must monitor for signs of bleeding, such as increased pain, decreased blood pressure, or vaginal bleeding.

Choice C rationale

Hypoxia, a deficiency in the amount of oxygen reaching the tissues, is not a direct immediate complication of amniocentesis for the mother. While fetal well-being is monitored during and after the procedure, maternal hypoxia is not a typical risk associated with the amniocentesis itself.

Choice D rationale

Infection is a significant potential complication following an amniocentesis. The invasive nature of the procedure creates a risk of introducing bacteria into the amniotic cavity or the maternal tissues. The nurse should observe for signs of infection such as fever, chills, abdominal tenderness, or leakage of fluid from the insertion site.