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A client arrives for her first prenatal appointment.

Exhibits

What is the correct way for the nurse to document the GTPAL for this client?

A.

G5 T2 P1 A1 L3

B.

G4 T2 P1 A1 L4

C.

G5 T1 P2 A1 L4

D.

G4 T1 P2 A1 L3

Answer and Explanation

The Correct Answer is B

  • G: 4 pregnancies (2017 spontaneous abortion, 2018 twins with one demise, 2020 NSVD, and the current pregnancy)
  • T: 2 term births (2020 and 2022)
  • P: 1 preterm birth
  • A: 1 abortion/miscarriage (2017 spontaneous abortion)
  • L: 4 living children (twins from 2018 and the child born in 2020)


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Related Questions

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"C"},"C":{"answers":"C"},"D":{"answers":"A"},"E":{"answers":"C"},"F":{"answers":"C"}}

Explanation

1st Trimester (Conception-13 weeks)

  • Fetus has a heartbeat: The fetal heartbeat can typically be detected around 6 weeks gestation using ultrasound, marking the beginning of cardiac development in the first trimester.

2nd Trimester (14-26 weeks)

  • Gender can be determined: Gender determination through ultrasound is generally possible around the 18-20 week mark in the second trimester when fetal genitalia are more distinguishable.

3rd Trimester (27-40 weeks)

  • Surfactant production: Surfactant production by the fetal lungs begins in the third trimester, usually around 24-28 weeks, but continues to increase throughout the remainder of pregnancy.
  • Sucking occurs: Fetal sucking movements start to develop around the 28th week and become more coordinated as the third trimester progresses.
  • Fetal respiratory movements begin: Fetal respiratory movements, where the fetus practices breathing by moving the diaphragm, begin in the third trimester to prepare for life outside the womb.
  • Increase in body fat: The fetus begins to accumulate more body fat in the third trimester, which helps with thermoregulation and provides energy reserves for birth and early postnatal life.

Finding

1st Trimester

Conception-13 weeks

2nd Trimester

14-26 weeks

3rd Trimester

27-40 weeks

Gender can be determined

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☒

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Surfactant production

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☐

☒

Sucking occurs

☐

☐

☒

Fetus has a heartbeat

☒

☐

Fetal respiratory movements begin

☐

☐

☒

Increase in body fat

☐

☐

☐

Correct Answer is A

Explanation

A. Administer parenteral antibiotics. The primary concern with premature rupture of membranes (PROM) is the risk of infection, so administering antibiotics is crucial to prevent infection in both the mother and fetus.
B. Prepare for delivery. Without signs of labor, the focus is on preventing infection and monitoring, not immediate delivery.
C. Provide emotional support. While important, the priority intervention is preventing infection.
D. Assess cervical dilation every 6 hours. Routine cervical checks are not typically necessary unless there are signs of labor or other indications.

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