A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year old child that was delivered at 37 weeks and tells the nurse that she doesn't have any history of abortion or fetal demise. The nurse would document the GTPAL for this client as:
1.G = 3, T = 2, P = 0, A = 0, L =1
2.G = 2, T = 0, P = 1, A = 0, L =1
3.G = 1, T = 1. P = 1, A = 0, L = 1
4.G = 2, T =
0, P = 0, A = 0, L = 1
1, 4, 5, and 6. The probable signs of pregnancy include uterine enlargement, Hegar's sign (softening and thinning of the uterine segment that occurs at week 6), Goodell's sign (softening of the cervix that occurs at the beginning of the 2nd month), Chadwick's sign (bluish coloration of the mucous membranes of the cervix, vagina, and vulva that occurs at week 6), ballottement (rebounding of the fetus against the examiners fingers of palpation), Braxton Hicks contractions and a positive pregnancy test measuring for hCG. Positive signs of pregnancy include fetal heart rate detected by electronic device (Doppler) at 10-12 weeks and by nonelectronic device (fetoscope) at 20 weeks gestation, active fetal movements palpable by the examiner, and an outline of the fetus via radiography or ultrasound.
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