Question

GOERMENT OF THE 369. A nurse is caring for a 24 year old client whose pregnancy history is as follows: elective termination in 1998, spontaneous abortion in 2001, term vaginal delivery in 2003, and currently pregnant again. Which documentation by the nurse of the client's gravity and parity is correct? A. G4P1 B. G4P2 C. G4PI D. G2PI 370. A pregnant client tells a nurse that she thinks she is carrying twins. In reviewing the client's history and medical records, the nurse should determine that which factors are associated with multiple gestation? Select all that apply. A. Elevated serum alph-fetoprotein B. Use of reproductive technology C. Maternal age greater than 40 D. Family history E. Elevated hemoglobin 371. At an inpatient psychiatric unit, a 40 year old woman insists on staying in her room and repeatedly comments to the nurse: "Special agents are here. Maybe you are one." Which of the following responses, if made by the nurse, is BEST? 1. "You can trust me. There are no agents here." 2. "You must feel afraid if you believe that, but there are no agents here." 3. "No one here will hurt you. They are here to help you." 4. "Agents? Tell me more about what you mean." 372.A postoperative client has returned to his room from the surgical recovery area. The client is sleeping, and the nurse noted the client is disoriented when aroused. Which of the following actions, if taken by the nurse, is BEST? 1. Place the call bell within the client's reach. 2. Stay with the client until he is totally oriented 3. Restrain all four extremities until the client is oriented 4. Elevate the side rails until the client is fully awake. 373. The nurse is caring for a patient with second-third-degree burns. The client is receiving morphine sulfate 15 mg IV. The nurse noted a decrease in bowel sounds

Answer 1

369. Gravidity refers to the number of pregnancies a person has had irrespective of the outcomes that is whether the pregnancies were stopped in between or resulted in live birth. Any current pregnancies is counted as gravidity. Parity refers to the number of births she had after viable gestational period (more than 20 weeks). These two terms are usually used hand in hand to indicate a patient’s obstetric history. In both cases, twin pregnancies are counted as 1.   

The client had elective termination in 1998, spontaneous abortion in 2001, vaginal delivery in 2003, and currently pregnant again. This means her gravidity is 4 (4 pregnancies in total) and parity is 1 (1 viable gestational period followed by live birth).

Hence, the correct documentation would be gravidity 4 and parity 1 (G4P1).

Thus, options A and D are correct.

370. A pregnancy consisting of more than one fetus is called multiple pregnancy. There are many factors that can cause multiple pregnancy. Some of these factors include:

• Heredity: Family history of multiple pregnancy increase the chances of having twins.
• Age: Women above the age of 30 can develop multiple conception.
• Parity: Having 1 or pregnancies earlier with multiple pregnancy before increase the chance of having twins.
• Use of ovulation stimulating medicines can increase the chance of multiple pregnancy.
• Reproductive technologies like in vitro fertilization (IVF) use medicines and techniqies that help to produce multiple eggs. These eggs are than fertilized in the lab and implanted in the uterus. Thus, the chance of each egg developing into embryo increases resulting in multiple pregnancy.

Elevated serum alph-fetoprotein indicate the developing fetus may have neural tube defect like spina bifida. It does not suggest development of multiple pregnancy.

Hence, option A is incorrect.

Elevated hemoglobin is also not an indicative factor for multiple pregnancy.

Hence, option E is not correct.

In reviewing the client’s history and medical records, factors associated with multiple gestation are:

Use of reproductive technology

Maternal age greater than 40

Family history

Therefore, the correct answer is options are B, C, and D.