A nurse is meeting with a group of pregnant clients who are in their last trimester to teach them the signs that may indicate they are going into labor.
The nurse determines the session is successful after the clients correctly choose which signs as an indication of starting labor? Select all that apply.

The correct answer is choice A.

Choice A rationale:

The GTPAL system stands for Gravida, Term, Preterm, Abortions, and Living children. In this case, the woman has been pregnant 4 times (Gravida 4), has had one term birth (Term 1), one preterm birth (Preterm 1), one abortion/miscarriage (Abortions 1), and one living child (Living 1). Therefore, the correct classification is 4, 1, 1, 1, 1.

Choice B rationale:

This choice incorrectly classifies the number of pregnancies (Gravida should be 4, not 3) and does not account for the preterm birth or the number of living children.

Choice C rationale:

This choice overcounts the number of term births and living children.

Choice D rationale:

This choice incorrectly classifies the number of pregnancies (Gravida should be 4, not 3) and overcounts the number of living children.

The correct answer is choice A.

Choice A rationale:

Evaluating the firmness of the uterus (fundus) is the first action the nurse should take when a client’s blood pressure drops postpartum. A soft or “boggy” uterus can indicate uterine atony, a leading cause of postpartum hemorrhage, which can lead to hypotension.

Choice B rationale:

Obtaining a type and crossmatch is important if the client needs a blood transfusion, but it is not the first action the nurse should take.

Choice C rationale:

Administering oxytocin infusion can help contract the uterus and control bleeding, but the nurse should first assess the uterus.

Choice D rationale:

Initiating oxygen therapy can help if the client is hypoxic, but the nurse should first assess the uterus.