The perinatal nurse is caring for a preeclamptic patient at 35 weeks' gestation. The patient's newest laboratory results include the following: platelet count 98,000/mm3 and RBC 3.1 million/ µL. What action by the nurse is most appropriate?
A.
Administer betamethasone (Celestone).
B.
Increase the patient's IV fluids.
C.
Maintain the patient on bedrest.
D.
Notify the health-care provider immediately.
ANS: D
This woman's laboratory values indicate the possible development of HELLP syndrome (hemolysis, elevated liver enzymes, low platelets), which is a factor that may necessitate immediate interventions to facilitate birth. Betamethasone is not given after 34 weeks' gestation. Increasing the IV fluids is not warranted. The patient should be maintained on bedrest, but notifying the provider is a priority.
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