The nurse in an OB clinic is completing an intake assessment of a client at the first prenatal appointment.
The client is currently 9 weeks pregnant.
She had a miscarriage at 7 weeks and an ectopic pregnancy at 6 weeks that was treated with methotrexate.
Her five-year-old son was born vaginally at 39 weeks and her three-year-old daughter was born vaginally at 35 weeks.
What is her GTPAL?
G4T1 P1 A1 L2.
G5T2 P0 A2 L2.
G5T1 P1 A2 L2.
G5T1 P1 A1 L3. .
The Correct Answer is C
Choice A rationale
G4T1 P1 A1 L2 implies the client has been pregnant 4 times, with 1 term birth, 1 preterm birth, 1 abortion, and 2 living children. This does not include the correct number of pregnancies or abortions for this client.
Choice B rationale
G5T2 P0 A2 L2 indicates 5 pregnancies, 2 term births, no preterm births, 2 abortions, and 2 living children. This does not correctly account for the preterm birth and abortion history provided.
Choice C rationale
G5T1 P1 A2 L2 is the correct answer, as it denotes 5 pregnancies (including the current one), 1 term birth, 1 preterm birth, 2 abortions, and 2 living children, aligning with the client's history.
Choice D rationale
G5T1 P1 A1 L3 indicates 5 pregnancies, 1 term birth, 1 preterm birth, 1 abortion, and 3 living children. The client has only 2 living children, so this is incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A reaction from an epidural can cause side effects such as hypotension and shivering, but it is not related to tachysystole.
Choice B rationale
When the fetus's heart rate drops below baseline, it is termed bradycardia, not tachysystole. This condition can occur due to various reasons, including cord prolapse or placental insufficiency.
Choice C rationale
Tachysystole is defined as more than five contractions in 10 minutes. This condition can lead to reduced blood flow to the fetus, resulting in fetal distress.
Choice D rationale
Pitocin is a medication used to induce labor and can cause tachysystole, but the administration of Pitocin itself is not the definition of tachysystole. It's the increased frequency of contractions that defines the condition.
Correct Answer is []
Explanation
The client most likely has umbilical cord compression, as evidenced by the presence of variable decelerations in fetal heart rate (FHR) and uterine tenderness. Umbilical cord compression is the most plausible condition given the symptoms and clinical indicators. Variable decelerations in FHR often indicate transient umbilical cord compression. Uterine tenderness can be associated with positional changes that exacerbate compression. These findings necessitate immediate intervention to improve fetal oxygenation and monitor ongoing fetal well-being.
Parameters:
- Variable decelerations in FHR: Indicate intermittent cord compression, leading to changes in fetal oxygenation, necessitating continuous monitoring.
- Uterine tenderness: Suggests possible positional issues or complications related to compression, requiring careful assessment to ensure optimal fetal and maternal health.
Actions:
- Change client position: Positional changes can relieve pressure on the umbilical cord, improving fetal oxygenation.
- Initiate continuous fetal monitoring: Essential to assess the ongoing status of fetal heart rate and detect any further decelerations or complications promptly.
Other Conditions:
- Dysfunctional labor: Typically associated with abnormal progression of labor, not directly indicated by variable decelerations or uterine tenderness alone.
- Placental abruption: Characterized by painful bleeding and abdominal pain, not suggested by the provided data.
- Pre-eclampsia: Marked by high blood pressure and proteinuria, absent in this case.
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