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 nurse should include in the teaching that a client who is 23 weeks pregnant can receive an influenza vaccination during pregnancy. This is because the influenza vaccine is safe and recommended for pregnant women to protect both the mother and the baby from the flu.

Choice B rationale

The rubella vaccine is a live vaccine and is not recommended during pregnancy or while breastfeeding due to the potential risk to the baby. However, it can be given immediately after delivery if the woman is not immune.

Choice C rationale

The varicella vaccine is also a live vaccine and is not recommended during pregnancy. It should be given before pregnancy or immediately after delivery if the woman is not immune.

Choice D rationale

The Tdap (Tetanus, Diphtheria, Pertussis) vaccine is actually recommended during each pregnancy, regardless of the patient’s previous history of receiving the vaccine. The optimal timing for Tdap administration is between 27 and 36 weeks of gestation.

Choice A rationale

Hypertension is the most common risk factor for placental abruption. Placental abruption occurs when the placenta partly or completely separates from the inner wall of the uterus before delivery. This can decrease or block the baby’s supply of oxygen and nutrients and cause heavy bleeding in the mother. Chronic high blood pressure (hypertension) is a known risk factor for placental abruption.

Choice B rationale

While blunt force trauma can be a cause of placental abruption, it is not the most common risk factor. Trauma or injury to the abdomen can cause placental abruption, but hypertension is a more common risk factor.

Choice C rationale

Cigarette smoking is a known risk factor for placental abruption, but it is not the most common risk factor. Smoking during pregnancy can increase the risk of placental abruption, but hypertension is a more common risk factor.

Choice D rationale

Cocaine use is a known risk factor for placental abruption, but it is not the most common risk factor. Use of cocaine during pregnancy can increase the risk of placental abruption, but hypertension is a more common risk factor.