Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

What additional parameter would indicate pre-eclampsia in a patient with elevated liver enzymes and low platelets?

1. Increased urinary output with ketonuria

2. Altered thyroid function tests

3. Altered hepatic function tests

4. Hyperreflexia of deep tendon reflexes

The correct answer is: Altered hepatic function tests

The identification of pre-eclampsia is critical in managing potential complications during pregnancy. The presence of elevated liver enzymes and low platelets already suggests the possibility of HELLP syndrome, which is a severe form of pre-eclampsia. To further substantiate the diagnosis of pre-eclampsia, it's essential to look for additional abnormalities in liver function tests. Altered hepatic function tests would indicate that there is ongoing liver dysfunction, which is a known complication of pre-eclampsia and HELLP syndrome. This can manifest as elevated levels of enzymes such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), reflecting significant liver involvement in these conditions. The other choices, while relevant in other clinical contexts, do not provide the same direct indication of worsening pre-eclampsia. Increased urinary output with ketonuria may suggest dehydration or diabetic ketoacidosis rather than a direct correlation with pre-eclampsia. Altered thyroid function tests could indicate thyroid issues but are not specifically tied to the diagnosis of pre-eclampsia. Hyperreflexia of deep tendon reflexes may be observed in various conditions, including severe pregnancy-related conditions, but it is not a specific indicator of liver dysfunction or