306 GTPAL and EDC more practice questions for Quiz and Exam

A woman reports that her last menstrual period (LMP) occurred February 1, 2017. Using the Naegele rule, what would be her estimated date of delivery (EDD)?

November 8, 2017 To determine the due date using Naegele rule, add 7 days to the date of the first day of the LMP, and then subtract 3 months.

A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks' gestation, a 2-year-old son born at 39 weeks' gestation, and a spontaneous abortion (miscarriage) 1 year ago at 6 weeks' gestation. Using the GTPAL method, the nurse would document her obstetric history as:

4 1 1 1 3 Using the GTPAL method, the woman's history would be documented as 4 (her fourth pregnancy), 1 (number of term pregnancies), 1 (number of pregnancies ending in preterm birth), 1 (number of pregnancies ending before 20 weeks or viability), and 3 (number of living children).

Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation.

4, 1, 1, 1, 1 The GTPAL system is used to classifying pregnancy status. G = gravida, T= term, P = preterm, A = number of abortions, L= number of living children.

A young couple are very excited to discover they are pregnant and ask the nurse when to expect the baby. Based on a July 20 LMP, which day will the nurse predict for delivery?

April 27 Naegele rule is to subtract 3 months and add 7 days from the first day of the last menstrual period to determine an expected due date, making the client's due date April 27.

At the first prenatal visit, the client reports her last menstrual period (LMP) was November 16. The nurse determines the estimated due date to be:

August 23 There are several methods to determine the estimated date of birth. Naegele rule can be used, which involves subtracting 3 months and then adding 7 days to the first day of the LMP. Then correct the year by adding 1 where necessary. Another method is to add 7 days and then add 9 months and add 1 to the year where needed. Thus the client reports her LMP was November 16 subtract 3 months (August), add 7 days (23), and adjust the year by adding 1 year. This client's estimated date of birth is August 23, in the following year.

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a 4-year-old child who was delivered at 38 weeks' gestation and tells the nurse that she does have a history of spontaneous abortion (miscarriage) within the first trimester. The nurse is correct to document the history as:

G = 3, T = 1, P = 0, A = 1, L = 1 The GTPAL stands for Gravida -- number of pregnancies, which is 3 (current, 4-year-old, and miscarriage); Term -- only one pregnancy thus far carried to term; Preterm deliveries -- 0; Abortions (including miscarriages) -- 1; Living children -- 1. Do not be distracted by the twins. That is still one pregnancy.

A nurse is classifying the pregnancy history of a woman who has had five pregnancies: three full-term, one preterm, and one abortion, with four children still living. How would the nurse document this information on the client's chart using the GTPAL system?

G5 P3114 The GTPAL system allows nurses to chart pregnancy history. G = gravida or the total number of pregnancies, which in this case equals five. P = para is the outcome of the pregnancies in the following order: full term, preterm, abortions, and living as of today. In this case, P3114.

The nurse is conducting the first prenatal assessment on a newly pregnant client. She shares with the nurse that she has 3 children, 2 born at full-term and one at 34 weeks' gestation. Her last pregnancy ended in a miscarriage. How should the nurse document this client's obstetrical history?

G5 T2 P1 A1 L3 One of the most common methods of recording the obstetric history is to use the acronym GTPAL. "G" stands for gravida, the total number of pregnancies including the current one. "T" stands for term, the number of pregnancies that ended at term (at or beyond 38 weeks' gestation); "P" is for preterm, the number of pregnancies that ended after 20 weeks and before the end of 37 weeks' gestation. "A" represents abortions, the number of pregnancies that ended before 20 weeks' gestation to include miscarriage. "L" is for living, the number of children delivered who are alive at the time of history collection. . For this client, G5 = current pregnancy (1) + children (3) + miscarriage (1); T2 = children born at 38+ weeks (2); P1 = children born between 20 and 37 weeks (1); A1 = abortion (0) + miscarriage (1); L3 = number of living children at time of assessment (3).

The nurse is documenting a non-pregnant client's obstetric history. The client informed the nurse she has 4 children living at home. She birthed one child at 34 weeks' gestation, one child at 37 weeks' gestation, one at 38 weeks' gestation, and one at 39 weeks' gestation. The client has had one abortion. Using the GTPAL format, how will the nurse document the client's obstetric history?

G5, T2, P2, A1, L4 "G" stands for gravida, the total number of pregnancies (5). "T" stands for term, the number of pregnancies that ended at term (at or beyond 38 weeks' gestation)(2). "P" is for preterm, the number of pregnancies that ended after 20 weeks' gestation (2). "A" is for abortions, either spontaneous or induced (1). "L" is for living, the number of children delivered who are alive at the time of history collection (4).

A woman reports that her LMP occurred on January 10, 2017. Using Naegele rule, what is her due date?

October 17, 2017 To determine the due date using Naegele rule, add seven days to the date of the first day of the LMP, then subtract three months.

A woman is concerned about the safety of continuing sex with her partner during pregnancy. Which suggestion should the nurse mention to her? Select all that apply.

Sex is to be avoided after your membranes have ruptured. Sex is generally not harmful to the fetus. Partner oral-female genital contact due to risk of air embolism. A nonmonogamous sexual partner should wear a condom. The nurse should reassure the client that sex is generally not harmful to the fetus. Women whose membranes have ruptured or who have vaginal spotting should be advised against sex until examined by their primary care provider to prevent possible infection. Advise caution also about partner oral-female genital contact, because accidental air embolism has been reported from this act during pregnancy as well as in the postpartum period from air entering open or fragile uterine arteries. Caution women with a nonmonogamous sexual partner that the partner needs to use a condom to prevent transmission of a sexually transmitted infection during pregnancy. Sex does not initiate labor or cause rupture of the membranes.

A pregnant woman reports her last child was born by cesarean birth. She questions if she will be required to have a cesarean birth for this current pregnancy. What information should be provided? Select all that apply.

The reason for the previous cesarean birth will aid in determining if a repeated cesarean birth will be performed. The type of incision into the uterus in the previous cesarean birth will be a factor for consideration. If the cesarean birth was due to pelvic size a repeated cesarean birth is likely indicated A woman who gives birth by cesarean may be a candidate for a future birth vaginally. The determination about the method of birth for a future birth will be based upon a series of factors. The underlying reason for the cesarean birth has a large impact. If the woman had an operative birth due to small pelvic size, structural deformities or contractures, a repeated cesarean birth will likely be indicated. This is because the problems will still be present in the next pregnancy. The type of incision on the uterus is also an important factor. If the uterine incision was a classical incision, a repeated cesarean is indicated. The classic incision places the uterus at a high risk for rupture. If the cesarean birth was due to fetal distress, the woman may be a candidate for a vaginal birth after cesarean birth.

The nurse is caring for several clients at the prenatal clinic. Which client would the nurse prepare for a routine fetal ultrasound?

a woman at 20 weeks gestation reporting increased nasal stuffiness A routine ultrasound to assess for fetal health is typically done at 16 to 20 weeks' gestation. The woman's concerns of nasal stuffiness are common during pregnancy and would not be the reason for the routine ultrasound. An ultrasound to assess for fetal health is not done preconception or in the last trimester. Concerns about insomnia are not reasons to complete a routine ultrasound in the last trimester. If the woman has an accurate date for the last menstrual period, a routine ultrasound is not performed so early in the pregnancy. Increased urination and fatigue are typical symptoms of pregnancy and would not be indications for a routine ultrasound.

Which information is most important in order to decrease the risk of complications if the client decides to work until her due date?

frequent rest periods It is common to have a client work until she goes into labor as long as she has had a low-risk pregnancy. Frequent rest periods are stressed, if possible, as the client progresses throughout the work day. The other options are good suggestions for any client at the end of pregnancy.

A nurse is documenting the obstetric history for a pregnant woman who has previously given birth to two infants at term and had one abortion at 12 weeks' gestation. How would the nurse document this information?

gravida 4 para 2 Gravida refers to the total number of pregnancies (including current), para to the number of births. The abortion would be noted as an "A" if using the full "GTPAL."

The nurse is caring for a client who is unsure why the health care provider ordered a sonogram to determine her due date. Which rationale would the nurse provide to this client?

it was needed due to irregular periods A sonogram is ordered to confirm the client's due date since the client has had irregular periods. Irregular periods make using Naegele rule difficult since it is important to know the first day of the last menstrual period. There are other ways to confirm that the client is pregnant. Past history does not impact the methods used to determine the due date. Treatment plans are developed from an accurately documented due date.

The nurse is assisting a primigravida on calculating the due date of her baby using Naegele rule. The most important information provided by the mother is:

the first day of the last menstrual period Naegele rule is calculated using the first day of the last menstrual period. From there, 7 days are added and then 3 months are subtracted. The ovulation date, intercourse date, or last day of the menstrual period are not needed.

A client comes to the prenatal clinic for her first visit. When determining the client's estimated date of delivery/birth, the nurse understands that which method is the most accurate?

ultrasound Although there are several methods for determining the EDD, the ultrasound is considered the most accurate method for dating the pregnancy.