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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 D

Explanation

Choice A rationale

Oxytocin is used to induce or augment labor, not typically used before an external version, which is a procedure to turn a breech baby to a head-down position.

Choice B rationale

Methylergonovine is used to prevent or control postpartum hemorrhage by inducing strong uterine contractions, not indicated before an external version.

Choice C rationale

Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor, not required for an external version.

Choice D rationale

Terbutaline is a tocolytic agent used to relax the uterus, making it easier to manipulate the fetus during the external version procedure.

Correct Answer is C

Explanation

Choice A rationale

While maternal lacerations are a risk during childbirth, they are not the greatest risk in cases of fetal dystocia. The focus is primarily on fetal wellbeing.

Choice B rationale

Fetal injury such as bruising can occur with dystocia, but the primary concern is the potential for severe, life-threatening complications.

Choice C rationale

Neonatal asphyxia related to prolonged labor is the greatest risk with fetal dystocia. Prolonged labor can lead to decreased oxygen supply to the fetus, causing asphyxia and

potential brain injury.

Choice D rationale

Increased consideration for a cesarean delivery is a possible outcome of fetal dystocia, but it is a management decision rather than a direct risk to the baby’s immediate health.

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