QLexNursing

🔷 Liver function tests – Improved

🔷 Day 1 labs showed AST 250 U/L, ALT 213 U/L, and bilirubin 30 mg/dL, which are highly elevated, indicating hepatic involvement typical of severe preeclampsia or HELLP syndrome.

🔷 On Day 2, there is a notable decline in liver enzymes and bilirubin levels (AST 113 U/L, ALT 94 U/L, bilirubin 18 mg/dL), indicating improvement in hepatic function.

🔷 The downward trend in these values demonstrates that the client is responding to treatment, particularly magnesium sulfate therapy.

🔷 These lab improvements signal a reduction in systemic inflammation and hepatic strain.

🔶 Edema – Improved

🔶 On Day 1, the client had +3 lower extremity edema and facial edema, signs of fluid retention and vascular permeability due to preeclampsia.

🔶 On Day 2, lower extremity edema decreased to +2, though facial edema remained, indicating partial fluid status improvement.

🔶 This change implies reduced capillary leakage or improved vascular tone.

🔶 Though not completely resolved, the lesser degree of edema represents clinical improvement.

💠 Fetal heart rate and variability – Declined

💠 FHR on Day 1 was 158 bpm with moderate variability and accelerations, showing good fetal oxygenation.

💠 By Day 2, the FHR dropped to the 120s, with minimal variability and no accelerations, indicating possible fetal distress or CNS suppression from worsening maternal status or magnesium.

💠 These non-reassuring signs suggest decreased fetal well-being and warrant prompt evaluation.

💠 The decline in variability and acceleratory patterns represents a deterioration in fetal condition.

🔵 Headache – Improved

🔵 On Day 1, the client reported a severe headache (8/10), a neurological sign of worsening preeclampsia.

🔵 On Day 2, headache intensity decreased to 2/10, showing response to magnesium sulfate and CNS stabilization.

🔵 This change demonstrates reduced cerebral vasospasm or pressure.

🔵 The relief of this symptom reflects a positive neurological response to treatment.

🟣 Epigastric discomfort – Improved

🟣 Epigastric pain was reported on Day 1, a red flag for possible hepatic capsule distension or HELLP syndrome.

🟣 On Day 2, the client denied epigastric pain, showing reduction in liver irritation or swelling.

🟣 The symptom resolution suggests improvement in hepatic inflammation and reduced risk of hepatic rupture.

🟣 This marks clear symptomatic improvement in maternal condition.

⚫ Urine dipstick – Not changed

⚫ On both days, the urine dipstick showed 2+ protein, reflecting persistent proteinuria, a hallmark of preeclampsia.

⚫ The absence of change indicates that renal involvement remains ongoing despite improvement in other symptoms.

⚫ This suggests stable but unresolved kidney pathology, requiring continued monitoring.

⚫ No improvement in this marker implies persistent glomerular permeability.