A pregnant woman comes to the prenatal clinic for an initial visit. In reviewing her childbearing history, the client indicated that she has delivered premature twins, one full-term baby, and has had no abortions. Which GTPAL should the nurse document in this client's record?
4-1-2-0-3
3-1-1-0-3
2-1-2-1-2
3-1-2-0-3
The Correct Answer is B
The correct answer is: B. 3-1-1-0-3.
Choice A reason:
This option suggests the woman has been pregnant four times, which is incorrect. She has had three pregnancies: one set of twins (counted as one pregnancy) and two singletons.
Choice B reason:
This is the correct option. The woman has had three pregnancies (Gravida = 3), one full-term delivery (Term = 1), one preterm delivery (the twins, Preterm = 1), no abortions (Abortions = 0), and three living children (Living = 3).
Choice C reason:
This option incorrectly suggests two preterm deliveries and one abortion, neither of which is indicated in the woman's history.
Choice D reason:
This option incorrectly suggests two preterm deliveries (the twins are counted as one preterm delivery) and does not accurately reflect the woman's history.
GTPAL stands for Gravida (total number of pregnancies), Term births (deliveries after 37 weeks), Preterm births (deliveries between 20-36 weeks), Abortions (losses before 20 weeks), and Living children. Normal ranges: Term (≥37 weeks), Preterm (20-36 weeks)
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Magnesium sulfate does not improve patellar reflexes and increase respiratory efficiency. In fact, it may cause hyporeflexia and respiratory depression as adverse effects. These are signs of magnesium toxicity and require immediate intervention.
Choice B reason: Magnesium sulfate does not prevent a boggy uterus and lessen lochial flow. A boggy uterus is a sign of uterine atony, which can lead to postpartum hemorrhage. Lochia is the normal vaginal discharge after childbirth. Magnesium sulfate has no effect on these conditions.
Choice C reason: Magnesium sulfate does not shorten the duration of labor. It may actually prolong labor by relaxing the uterine muscles and inhibiting contractions. Magnesium sulfate is not used to induce or augment labor.
Choice D reason: Magnesium sulfate is used to prevent and treat convulsions in women with preeclampsia and eclampsia. Convulsions are a life-threatening complication of severe hypertension during pregnancy. Magnesium sulfate acts as a central nervous system depressant and anticonvulsant. It reduces the risk of seizures and lowers blood pressure.
Correct Answer is D
Explanation
Choice A reason: This is not a good intervention, as it may worsen the symptoms of faintness, dizziness, and agitation. Standing up can cause a sudden drop in blood pressure (orthostatic hypotension), which can reduce the blood flow to the brain and the fetus. This can cause lightheadedness, blurred vision, and loss of consciousness in the woman, as well as fetal distress or hypoxia.
Choice B reason: This is not a good intervention, as it may also worsen the symptoms of faintness, dizziness, and agitation. Lying supine can cause compression of the inferior vena cava (a large vein that returns blood to the heart) by the gravid uterus, which can reduce the cardiac output (the amount of blood pumped by the heart) and the blood pressure. This can cause nausea, sweating, and visual disturbances in the woman, as well as fetal distress or hypoxia.
Choice C reason: This is not a good intervention, as it may not improve the symptoms of faintness, dizziness, and agitation. Sitting down and holding the arm in a dependent position can lower the blood pressure in the arm, but not in the rest of the body. This can cause inaccurate readings of the blood pressure and delay the detection of hypotension or hypertension. This can also cause discomfort and pain in the arm due to impaired circulation.
Choice D reason: This is the best intervention, as it can relieve the symptoms of faintness, dizziness, and agitation by improving the blood flow to the brain and the fetus. Turning to the left side can reduce the pressure of the uterus on the inferior vena cava and increase the cardiac output and the blood pressure. This can also optimize the placental perfusion (the blood flow to the placenta) and the fetal oxygenation.
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