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Which of the following physical findings would lead the nurse to suspect that a client who has pre-eclampsia with severe features has developed HELLP syndrome? Select all that apply.

A.

Petechiae.

B.

Jaundice.

C.

4+ deep tendon reflexes.

D.

3+ pitting edema.

Question Solution

Correct Answer : A,B,D

Choice A rationale

Petechiae, small red or purple spots on the skin, indicate a low platelet count, which is a component of HELLP syndrome.

 

Choice B rationale

Jaundice, a yellowing of the skin and eyes, suggests liver involvement and hemolysis, both of which are features of HELLP syndrome.

 

Choice C rationale

4+ deep tendon reflexes are associated with severe pre-eclampsia but are not specific to HELLP syndrome.

 

Choice D rationale

3+ pitting edema, severe fluid retention causing swelling, can be a sign of HELLP syndrome, indicating liver or kidney involvement. .


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Correct Answer is B

Explanation

Choice A rationale

While massaging the fundus and ensuring IV access are correct initial actions, methylergonovine (Methergine) is typically used for patients without hypertensive history due to its

potential to raise blood pressure.

Choice B rationale

This option correctly identifies initial steps and appropriate medication. Carboprost-tromethamine (Hemabate) is effective in controlling postpartum hemorrhage and can be safely

used in patients with hypertension when oxytocin is insufficient.

Choice C rationale

Quantifying blood loss is essential but it is not an immediate priority when the patient is showing signs of significant bleeding and instability. Immediate intervention to control bleeding

takes precedence.

Choice D rationale

Assisting the patient to the restroom and then massaging the fundus overlooks the immediate need to control bleeding. This approach may delay necessary treatment and increase

the risk of further hemorrhage.

Choice E rationale

Straight catheterization and oxytocin maintenance are part of the management of postpartum hemorrhage but do not address the immediate need to ensure uterine contraction and

control active bleeding as effectively as the initial steps outlined in Choice B. .

Correct Answer is C

Explanation

Choice A rationale

Magnesium sulfate is primarily used for neuroprotection in preterm infants and to prevent seizures in severe preeclampsia, not as a first-line tocolytic for preterm labor.

Choice B rationale

Morphine sulfate is an opioid analgesic used for pain management, not for inhibiting preterm labor contractions.

Choice C rationale

Terbutaline is a beta-agonist used as a tocolytic to relax uterine muscles and delay preterm labor. It helps decrease the intensity and frequency of contractions, making it suitable for managing preterm labor.

Choice D rationale

Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor, not for direct contraction inhibition.

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