A nurse in a prenatal clinic is examining the health record of a client who is 28 weeks pregnant.
The history includes one pregnancy terminated by elective abortion at 9 weeks, the birth of twins at 36 weeks, and a spontaneous abortion at 15 weeks.
According to the GTPAL system, how would you describe the client’s current status?

Choice A rationale

While determining the viability of the fetus is an important aspect of prenatal care, it is not the primary purpose of an ultrasound in this scenario. The client’s report of feeling the baby moving suggests that the fetus is likely viable.

Choice B rationale

The primary purpose of the ultrasound in this scenario is to locate the placenta. Heavy, red vaginal bleeding at 38 weeks of gestation could indicate a complication such as placenta previa, where the placenta covers the cervix. An ultrasound can help confirm this diagnosis.

Choice C rationale

Measuring the biparietal diameter is a method used to estimate fetal weight and gestational age. However, in this scenario, the client is already known to be at 38 weeks of gestation, and the sudden onset of heavy, red vaginal bleeding is a more immediate concern.

Choice D rationale

Assessing fetal lung maturity is typically done when there is a risk of preterm delivery. In this scenario, the client is already at 38 weeks of gestation, which is considered full term. The immediate concern is the heavy, red vaginal bleeding.

Choice A rationale

Chloasma. Also known as melasma or the “mask of pregnancy,” chloasma is a common skin change during pregnancy. It appears as dark, irregular patches on the face19.

Choice B rationale

Linea nigra. This is a dark line that runs from the belly button to the pubic hair. It is another common skin change during pregnancy19.

Choice C rationale

Eczema. While some women may experience a worsening of eczema symptoms during pregnancy, it’s not a skin change that’s specifically associated with pregnancy19.

Choice D rationale

Psoriasis. Like eczema, psoriasis is not a skin change that’s specifically associated with pregnancy. Some women may see their psoriasis improve during pregnancy, while others may see it get worse19.

Choice E rationale

Striae gravidarum. Also known as stretch marks, these are another common skin change during pregnancy. They appear as pink, red, or purple streaks on the skin19.