Question

A client with preeclampsia is admitted to the labor and birthing suite. Her blood pressure is 130/90 mm Hg, and she has 2+ protein in her urine along with edema of the hands and face. Which signs or symptoms would the client display if she were developing hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome)? Select all that apply.

a. Headache
b. Constipation
c. Abdominal pain
d. Vaginal bleeding
e. Flulike symptoms

Answer 1

Clients with HELLP syndrome may experience severe headache, abdominal pain, particularly in the upper right quadrant due to liver involvement, and general flulike symptoms including malaise, nausea, and vomiting. Constipation and vaginal bleeding are not classic signs of HELLP syndrome, but abdominal pain is specifically significant because it can indicate liver distress.

Step-by-step explanation:

A client with preeclampsia who is at risk of developing HELLP syndrome may exhibit several nonspecific signs and symptoms. Among the options listed, the ones that apply to the development of HELLP syndrome are:

• Headache - Often severe and may be accompanied by visual disturbances.
• Abdominal pain - Particularly in the upper right quadrant, which can indicate liver involvement. This pain is due to liver swelling and capsular stretch.
• Flulike symptoms - General malaise and feeling unwell, which can include nausea, vomiting, and fatigue.

While constipation and vaginal bleeding are not classic symptoms of HELLP syndrome, they can be associated with pregnancy and complications thereof. Significantly, the abdominal pain associated with HELLP syndrome may be misinterpreted as dyspepsia, flu, or acute hepatitis. However, the correct identification of these symptoms as part of HELLP syndrome is critical due to potential severe complications such as liver rupture or stroke. Proteinuria, edema, and hypertension are the hallmark findings of preeclampsia, which when coupled with the aforementioned symptoms, warrant a thorough evaluation for HELLP syndrome.