GTPAL and Gravida Para need explanation?

[studentnurse0221]

Scenario: Sandra delivered a baby boy at 38 weeks gestation, twin girls at 36 weeks, and had a miscarriage at 11 weeks. Which of the following should the nurse document: document Gravia and Para as well.

a. G3 T2 P1 A1 L3

b. G4 T2 P2 A1 L3

c. G3 T1 P2 A1 L3

d. G4 T1 P1 A1 L3

My answer is A. But I'm not sure with that, really confuse. HELP! THANKS!

[sameasalways, ASN, RN]

So a mother of twins that were premature would be gravida 1, para 2 (G1P2) And would be G:1 T:0 P:1 A:0 L:2 If these are used independently they give the same outcome: (the mother was pregnant once and had 2 children, but the GTPAL gives a broader picture of the history). When I worked in the Ob clinic the Dr. never used GTPAL...only in the medical record. But in general everyday conversation he refered to the patients as the first acronym. Maybe this is wrong...but that is how I learned it and how we made sense out of it in nursing school when this same argument came up. We clarified it by noting that these are two different ways of stating what happened.. the P standing for Para vs. Preterm.

[foreverLaur]

sameasalways said:

So a mother of twins that were premature would be gravida 1, para 2 (G1P2) And would be G:1 T:0 P:1 A:0 L:2 If these are used independently they give the same outcome: (the mother was pregnant once and had 2 children, but the GTPAL gives a broader picture of the history). When I worked in the Ob clinic the Dr. never used GTPAL...only in the medical record. But in general everyday conversation he refered to the patients as the first acronym. Maybe this is wrong...but that is how I learned it and how we made sense out of it in nursing school when this same argument came up. We clarified it by noting that these are two different ways of stating what happened.. the P standing for Para vs. Preterm.

Wouldn't it be G1 P1? One pregnancy, one birth (regardless of the # of infants born) ?

[strn96]

I have seen both ways of documenting parity for multiples. There is definite disagreement, both among textbooks & doctors. I have heard it explained both ways: that parity is the number of pregnancies delivered which in this case would be G3 T1 P1 A1 L3. I've also seen it where each infant is considered a separate delivery which would make the answer G3 T1 P2 A1 L3. In school, I was taught the 1st way, but since working in OB I've been shown "proof" that the 2nd way of documentation is correct. If given a multiple choice question involving twins or multiples, I would look first at the all the other factors - G, T, A, L if multiples were preterm or G, P, A, L if multiples were term (keep in mind that everyone agrees that the G stands for # of pregnancies, not # of babies - so twins would definitely be 1 pregnancy), and then base T or P on whichever answer fits with the other 4 factors. If there is more than one answer that fits, go with whatever your textbook says. At least you're up to a 50% chance of getting it right.

Also, keep in mind that "P" in GTPAL stands for "preterm", not "para"; "para" is total number of deliveries, both term and preterm.

[foreverLaur]

For purposes of the NCLEX - which way should I do it?

[iteachob, MSN, RN]

foreverLaur said:

For purposes of the NCLEX - which way should I do it?

Well....I know the way KAPLAN teaches it, and it's not the way you were taught.

[bmayo8155]

GTPAL explained

[Sweet charm, ASN, RN]

According to Uworld the answer would be C

[klone, MSN, RN]

Sweet charm said:

According to Uworld the answer would be C

U World would be wrong. The answer is none of the above.