Exhibits

The nurse is reviewing nurses' notes to determine what the client's obstetric history reveals in the form of GTPAL.

Choose the most likely option for the information missing from the statement by selecting from the list of options provided.
Based on the client's obstetrical history, the client's G-T-P-A-L designation is____________.

A. G (Gravida): This refers to the total number of pregnancies, including the current pregnancy. Since the client is currently pregnant, and she has had three previous pregnancies and one of which was a spontaneous abortion, the total is 5 (1 current pregnancy + 3 previous births + 1 spontaneous abortion). T (Term births): The client has had two full-term births (one at 38 weeks and one at 41 weeks), so T = 2. P (Preterm births): The client has had one preterm birth (at 35 weeks), so P = 1. A (Abortions/miscarriages): The client had one spontaneous abortion at 10 weeks, so A = 1. L (Living children): The client has four living children, so L = 4.

B. G (Gravida): This refers to the total number of pregnancies, including the current pregnancy. Since the client is currently pregnant, and she has had three previous pregnancies and one of which was a spontaneous abortion, the total is 5 (1 current pregnancy + 3 previous births + 1 spontaneous abortion). T (Term births): The client has had two full-term births (one at 38 weeks and one at 41 weeks), so T = 2. P (Preterm births): The client has had one preterm birth (at 35 weeks), so P = 1. A (Abortions/miscarriages): The client had one spontaneous abortion at 10 weeks, so A = 1. L (Living children): The client has four living children, so L = 4.

C. G (Gravida): This refers to the total number of pregnancies, including the current pregnancy. Since the client is currently pregnant, and she has had three previous pregnancies and one of which was a spontaneous abortion, the total is 5 (1 current pregnancy + 3 previous births + 1 spontaneous abortion). T (Term births): The client has had two full-term births (one at 38 weeks and one at 41 weeks), so T = 2. P (Preterm births): The client has had one preterm birth (at 35 weeks), so P = 1. A (Abortions/miscarriages): The client had one spontaneous abortion at 10 weeks, so A = 1. L (Living children): The client has four living children, so L = 4.

D. G (Gravida): This refers to the total number of pregnancies, including the current pregnancy. Since the client is currently pregnant, and she has had three previous pregnancies and one of which was a spontaneous abortion, the total is 5 (1 current pregnancy + 3 previous births + 1 spontaneous abortion). T (Term births): The client has had two full-term births (one at 38 weeks and one at 41 weeks), so T = 2. P (Preterm births): The client has had one preterm birth (at 35 weeks), so P = 1. A (Abortions/miscarriages): The client had one spontaneous abortion at 10 weeks, so A = 1. L (Living children): The client has four living children, so L = 4.

Rationale:

• pH 7.40: A pH of 7.40 indicates that the client's acid-base balance is normal. This supports ventilation as the client’s respiratory system is effectively managing gas exchange.
• Blood pressure 112/77 mm Hg: This stable blood pressure is a sign that the client is adequately perfused, indicating management of hypovolemia. The blood pressure is now within a normal range, suggesting effective fluid resuscitation.
• PaCO2 42 mm Hg: The PaCO2 of 42 mm Hg is within normal limits, showing that the client's ventilation is adequate and confirming support of ventilation.
• Surgical dressing dry and intact: The intact dressing is important for preventing infection, as it ensures that there is no leakage or exposure to bacteria at the surgical site.
• Temperature 98.1° F (36.7° C): A temperature of 98.1° F (36.7° C is a normal and suggests successful rewarming or maintenance of normothermia, which contributes to Prevent infection as hypothermia can impair immune function and increase infection risk.
• Capillary refill 2 seconds: Capillary refill of 2 seconds is within normal limits and indicates good circulation and tissue perfusion, which is part of managing hypovolemia.
• Pain 0 on a scale of 0 to 10: The client’s report of no pain (pain score of 0) indicates that the goal of controlling pain and anxiety is being met, ensuring that the client is comfortable and stable.