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

The symptoms described by the client do not typically align with conditions that would lead to Anticipate A. Anticipate A might be expected for a different set of symptoms or conditions.

Choice B rationale

The symptoms described by the client do not typically align with conditions that would lead to Anticipate B. Anticipate B might be expected for a different set of symptoms or conditions.

Choice C rationale

The symptoms described by the client do not typically align with conditions that would lead to Anticipate C. Anticipate C might be expected for a different set of symptoms or conditions.

Choice D rationale

The client’s symptoms of recent painful sores on the perineum, muscle aches, and chills, along with current discomfort when sitting and mild vaginal itching, could suggest a herpes simplex virus infection or another type of infection. Anticipate D might be an antiviral medication or other treatment to address the suspected condition.

Choice A rationale

While bile does play a role in digestion, it is not retained in the liver. Instead, it is produced by the liver and stored in the gallbladder. When food enters the small intestine, the gallbladder releases bile to aid in the digestion of fats. However, this process is not directly related to heartburn during pregnancy.

Choice B rationale

During pregnancy, the body produces large amounts of the hormones progesterone and relaxin. These hormones tend to relax smooth muscle tissues throughout the body, including those in the gastrointestinal (GI) tract. As a result, food sometimes moves more slowly through the system, resulting in indigestion issues of all kinds, from that bloated, gassy feeling to heartburn. This is the correct answer because increased progesterone production does indeed cause decreased motility of smooth muscle, which can lead to heartburn.

Choice C rationale

While estrogen levels do increase during pregnancy, they do not directly cause an increase in the secretion of hydrochloric acid. Instead, the relaxation of the lower esophageal sphincter due to pregnancy hormones can allow stomach acid to flow back up into the esophagus, causing heartburn.

Choice D rationale

While it is true that the growing uterus can displace the stomach, especially in later stages of pregnancy, this is not the primary cause of heartburn. Heartburn is primarily caused by the relaxation of the lower esophageal sphincter, allowing stomach acid to flow back up into the esophagus.