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Nursing QUESTION #9132
Question 1
A pregnant woman at 34 weeks presents with sudden onset epigastric/right upper quadrant pain, nausea, vomiting, and jaundice. Labs show: platelets 78,000/µL, AST 320 U/L, LDH 890 U/L, Hb 8.2 g/dL (falling). This BEST describes:
  • Severe Preeclampsia only
  • HELLP Syndrome✔️
  • Acute Fatty Liver of Pregnancy
  • Cholestasis of Pregnancy
Correct Answer Explanation

HELLP Syndrome is a severe complication of preeclampsia:

Hemolysis + Elevated Liver enzymes + Low Platelets

FindingDiagnostic CriterionThis Patient
Hemolysis (falling Hb, high LDH)LDH \(>600\,\text{U/L}\)LDH 890 ✓
Elevated liver enzymesAST/ALT \(>70\,\text{U/L}\)AST 320 ✓
Low platelets\(<100{,}000/\mu\text{L}\)78,000 ✓

Management:

  • Immediate hospitalization, stabilization
  • IV MgSO₄ for seizure prophylaxis
  • Antihypertensives if BP \(\geq 160/110\,\text{mmHg}\)
  • Corticosteroids (dexamethasone) to improve platelet count temporarily
  • Delivery is the definitive treatment (regardless of gestational age if \(\geq 34\) weeks)
  • Platelet transfusion if \(<50{,}000\) before CS or \(<20{,}000\) with vaginal delivery