A client at 39 weeks gestation is admitted in early labor. During the focused assessment, the practical nurse (PN) reviews the obstetrical history of the client who states that she has been pregnant five times but has only two living children, both of whom were full-term. The other three pregnancies were miscarriages during the first trimester. Which parity should the PN document for the term, premature, abortion, and living children (TPAL) for this client?
A.
Term 2, Premature 0, Abortion 3, Living 2.
B.
Term 6, Premature 3, Abortion 3, Living 2.
C.
Term 2, Premature 1, Abortion 0, Living 3.
D.
Term 3, Premature 0, Abortion 3, Living 2.
The correct answer and Explanation is :
The correct answer is:
A. Term 2, Premature 0, Abortion 3, Living 2.
Explanation:
The TPAL system is a method used to summarize a woman’s obstetric history. It stands for:
- T: Number of term deliveries (delivered at 37 weeks’ gestation or later)
- P: Number of preterm deliveries (delivered between 20 and 36 weeks’ gestation)
- A: Number of pregnancies lost due to spontaneous or elective abortions before 20 weeks’ gestation
- L: Number of living children
Given the client’s history:
- Term Deliveries (T): The client has two living children, both of whom were full-term. This means she has had 2 term deliveries.
- Premature Deliveries (P): There is no information indicating that any of her pregnancies were delivered before 37 weeks of gestation. Therefore, the number of premature deliveries is 0.
- Abortions (A): The client had three miscarriages during the first trimester, which fall under the category of abortions. Therefore, the number of abortions is 3.
- Living Children (L): The client currently has two living children.
Thus, the TPAL documentation for this client should be:
- Term (T): 2
- Premature (P): 0
- Abortion (A): 3
- Living (L): 2
Option A correctly reflects these values.
This system helps in providing a concise summary of a patient’s obstetric history and can be crucial in assessing risks and managing care during labor and delivery.