A nurse in a prenatal clinic is examining the health record of a client who is 28 weeks pregnant.
The history includes one pregnancy terminated by elective abortion at 9 weeks, the birth of twins at 36 weeks, and a spontaneous abortion at 15 weeks.
According to the GTPAL system, how would you describe the client’s current status?

Choice A rationale

A negative rubella titer indicates that the client does not have immunity to the rubella virus. Therefore, the statement that the client is immune to the rubella virus is incorrect.

Choice B rationale

While it is true that a person with a negative rubella titer needs a rubella vaccination, it is not recommended to administer the vaccine immediately during pregnancy due to the potential risks to the fetus. Therefore, this statement is not correct in this context.

Choice C rationale

The correct interpretation of a negative rubella titer in an antepartum client is that the client should receive a rubella immunization post-delivery. This is because rubella can cause serious complications if contracted during pregnancy, including congenital rubella syndrome in the newborn. Vaccination post-delivery will protect the client in future pregnancies.

Choice D rationale

A negative rubella titer does not provide information about whether the client is currently infected with the rubella virus. It only indicates that the client does not have immunity to the virus. Therefore, this statement is not a correct interpretation of the data.

Choice A rationale

Urinary frequency is a common early symptom of pregnancy. It’s caused by an increase of the hormones progesterone and human chorionic gonadotropin (hCG). The urges tend to reduce in the second trimester. Most women find they have to pee with even more frequency late in pregnancy, from about week 35 on. Near the end of the third trimester, when your baby is preparing for childbirth, the head “drops” down into the pelvis and presses squarely on your bladder — which means you’ll have that gotta-go urge more than ever.

Choice B rationale

While it’s true that urinary frequency can reduce after the first trimester, it’s not accurate to say that it only lasts until the 12th week for most cases. It’s also not entirely dependent on bladder tone. The frequency of urination during pregnancy is primarily due to hormonal changes and the growing uterus putting pressure on the bladder.

Choice C rationale

Although the duration of urinary frequency can vary among individuals, it’s not accurate to say that there’s no way to predict how long it will last in each individual client. Generally, urinary frequency is common during the first trimester and tends to reduce in the second trimester, only to increase again around week 352.

Choice D rationale

Labeling urinary frequency as a “minor inconvenience” that should be ignored is not an appropriate response. It’s important to validate the client’s experiences and provide accurate information. Urinary frequency is a normal part of pregnancy due to increased hormones and pressure on the bladder from the growing uterus.