A nurse in a prenatal clinic is reviewing the medical record of a client who is at 28 weeks of gestation. The client's history reveals one pregnancy terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks of gestation. According to the GTPAL system, which of the following describes her present parity?
4-0-0-2-2
4-2-0-2-2
4-0-2-2-2
4-0-1-2-2
The Correct Answer is D
G (Gravida) — Total number of pregnancies, including the current one.
Elective abortion at 9 weeks
Birth of twins at 36 weeks
Spontaneous abortion at 15 weeks
Current pregnancy at 28 weeks So, G = 4.
T (Term births) — Number of pregnancies carried to 37 weeks or beyond.
-
- She hasn't had any pregnancies reach full term. So, T = 0.
P (Preterm births) — Number of pregnancies delivered between 20 and 36 weeks.
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- Twins born at 36 weeks. So, P = 1.
A (Abortions) — Number of pregnancies ending before 20 weeks (spontaneous or elective).
-
- Elective abortion at 9 weeks
- Spontaneous abortion at 15 weeks So, A = 2.
L (Living children) — Number of living children.
-
- The twins are living children. So, L = 2.
Putting it all together, her GTPAL notation is G4 T0 P1 A2 L2.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The nurse's first action should be to massage the client's fundus, as this can help stimulate uterine contraction and prevent hemorrhage. The fundus is the upper part of the uterus that contracts and involutes after delivery to compress the blood vessels and stop bleeding. The nurse should palpate the fundus for firmness, height, and position, and massage it gently if it is boggy or displaced.
The other actions are not the first priority and may be done after massaging the fundus.
The nurse should observe for the pooling of blood under the buttocks, as this can indicate a large amount of blood loss that may not be visible on the perineal pad. However, this is not the first action to take, as it does not address the cause of the bleeding or stop it from continuing.
The nurse should assess the client's blood pressure, as this can indicate the severity of blood loss and the presence of shock. However, blood pressure may not change significantly until a large amount of blood is lost, and it is not specific to the cause of bleeding. Therefore, blood pressure is not the first action to take.
The nurse should prepare to administer a prescribed oxytocic preparation, such as oxytocin or methylergonovine, as this can enhance uterine contraction and reduce bleeding. However, this requires a provider's order and may take time to obtain and administer. Therefore, an oxytocic preparation is not the first action to take.
Correct Answer is D
No explanation
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