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

A cough and fever in a client at 38 weeks of gestation could indicate an infection, which should be addressed promptly. However, it is not as immediately life-threatening as painless vaginal bleeding at 28 weeks of gestation, which could indicate a serious complication such as placental abruption.

Choice B rationale

Nausea and vomiting at 14 weeks of gestation are common symptoms of early pregnancy and, while uncomfortable, are not usually a sign of a serious problem. This client should be seen, but not before a client with a potentially life-threatening condition like painless vaginal bleeding.

Choice C rationale

Painless vaginal bleeding at 28 weeks of gestation is a serious symptom that could indicate placental abruption, a condition where the placenta detaches from the uterus, which can be life-threatening for both the mother and the baby. This client should be seen first.

Choice D rationale

Vaginal spotting in a client who has missed a period could indicate early pregnancy or a number of other conditions. While this client should be seen to confirm the cause of the spotting, it is not as immediately urgent as painless vaginal bleeding at 28 weeks of gestation.

Choice C rationale

While moderate caffeine consumption is generally considered safe during pregnancy, it’s important to note that caffeine is a stimulant and can increase heart rate and blood pressure, which can potentially affect the baby. Some studies also suggest that high caffeine intake may increase the risk of preterm birth or low birth weight. Therefore, it’s often recommended that pregnant women limit their caffeine intake.