GTPAL and Gravida Para need explanation? - page 2

by studentnurse0221

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Scenarion: Sandra delivered a baby boy at 38 weeks getation, 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.... Read More


  1. 1
    Quote from foreverLaur
    Gravida: any pregnancy (including current), regardless of duration
    Term: number of term infants born (37 weeks or beyond)
    Preterm: number of preterm infants born (after 20 weeks but before 37 weeks)
    Abortion: number of pregnancies ending in either spontaneous or elective abortion
    Living: number of currently living children to whom the woman has given birth

    Thus, gravida and abortions refer to # of pregnancies and term/preterm/living refers to the actual number of infants.

    The answer is
    G: 3
    T: 1
    P: 2
    A: 1
    L: 3
    Which is C!

    This is per Old's Maternal-Newborn Nursing & Women's Health Across the Lifespan 8th edition by Davidson, London, Ladewig on pg 338.

    iteachob - where did you get your information? It contradicts what I was taught in school, what is in my textbook, and what all area hospitals are using.
    My info is from NUMEROUS sources (and years of experience). By the way, my username....iteachob.......means I teach OB. I've taught it for over 10 years. Trust me. I know what I'm talking about. I am also a Kaplan NCLEX instructor.

    A, B, C, and D are all incorrect.
    Last edit by iteachob on Nov 28, '11
    demylenated likes this.
  2. 0
    Quote from EveRose
    I'm currently taking Maternal Child and our text teaches it the same as iteachbob. Maternal-Child Nursing 3rd edition by McKinney, James, Murray, Ashwell pg 262
    G: 3 T: 1 P: 1 A: 1 L: 3
    P is one - the number of fetuses in pregnancy doesn't change the para
    I live in Iowa and this is what the hospitals use here.

    I was not including para in my answer. I was including gravida, term, preterm, abortion, and living. You are correct that para is number of births and does not take into account the number of children. That's why para is broken down into term, preterm, abortion, and living.
  3. 0
    Quote from iteachob
    By the way, my username....iteachob.......means I teach OB.
    LOL HAHA

    Just don't know why, but the fact that this was (or, had to be) pointed out caught my funny bone...

    And, yup - I am back in school (ugh) and all 3 of my maternal child books (last three versions, current newest version) and 2 saunders NCLEX study books have your info as correct Quick web search confirms it. Multiples do not equal a higher G, T, or P number it is just PER delivery.

    So, I trust your info
  4. 0
    i was taught the same as iteachob says. those are the number of pregnancies, not fetuses. i'm currently in my preceptorship in L&D, and we use the same way there.
  5. 1
    We were taught that Para is broken down into "term, preterm, abortion, living" in order to show the number of fetuses since para does not do that. My textbook explains it the same way - gravida, para, and abortion are number of pregnancies and term, preterm, and living are number of fetuses.

    Like I said above, my textbook, my school, and all area hospitals use this method.

    I also checked "Maternal-Newborn Nursing Reviews and Rationales" by Prentice Hall which is a NCLEX review book and it defines them as

    Gravida - the # of times a woman has been pregnant
    Para - the number of births after 20 weeks gestation, born dead or alive (multiple births count as one delivery regardless of the number of infants delivered)
    Term - number of term infants born after 37 weeks
    Preterm - number of premature infants born between 20 and 37 weeks
    Abortion - number of pregnancies that end in spontaneous of therapeutic abortion prior to 20 weeks
    Living - number of children currently alive

    So how is one supposed to know which is correct? The above definitions I just stated are in TWO independent nursing textbooks and several people on this forum have same different nursing textbooks define it differently.

    Do we just go by "hospital policy" for how to use these? Now I am worried about the NCLEX examination since we were taught the whole purpose of using GTPAL instead of GP is to break it down so you can tell about multiple births (twins) and now I am learning that I was taught incorrectly and my textbook is incorrect.
    demylenated likes this.
  6. 0
    Quote from foreverLaur
    Now I am worried about the NCLEX examination since we were taught the whole purpose of using GTPAL instead of GP is to break it down so you can tell about multiple births (twins) and now I am learning that I was taught incorrectly and my textbook is incorrect.
    Good question... go on a hope and a prayer that we don't get that question on the NCLEX.
  7. 0
    Quote from foreverLaur
    I was not including para in my answer. I was including gravida, term, preterm, abortion, and living. You are correct that para is number of births and does not take into account the number of children. That's why para is broken down into term, preterm, abortion, and living.
    But it's still "pregnancy episodes" rather than number of babies in the T and P. That's why the L is there too.
  8. 0
    Quote from klone
    But it's still "pregnancy episodes" rather than number of babies in the T and P. That's why the L is there too.
    I get that, but that's not how my school teaches it, that's not how my textbook teaches it, and that's not how our area hospitals do it. We do number of babies, not pregnancies for T (term) and P (preterm)
  9. 0
    Quote from foreverLaur
    I get that, but that's not how my school teaches it, that's not how my textbook teaches it, and that's not how our area hospitals do it. We do number of babies, not pregnancies for T (term) and P (preterm)
    How many area hospitals have you worked in OB as a nursing student? Just wondering how many hospitals y ou've seen this at. As you can see, this is a commonly misunderstood point, and many OB nurses don't even follow it correctly.

    Out of curiosity, what textbook do you use, and could you quote here the specific info it gives regarding calculating GPTAL?
    Last edit by klone on Dec 1, '11
  10. 0
    I've looked at 7 different OB nursing texts that are sitting here in my office. Here's what I have found. Olds, London and Ladewig (a text I have never used) does indeed say # of infants. However, (1) Pillitteri; (2) Lowdermilk & Perry (I have used this text) ; (3) Sherwin, Scoloveno & Weingarten; (4) Murray & McKinney (I currently use this text); (5) The Lippincott Manual of Nursing Practice; and (6) Ward & Hisley all refer to them as # of pregnancies delivered.
    So, it seems that there is some debate on this subject. The evidence appears to be weighted heavily in the # of delivered pregnancies vs. # of infants, though.
    Silvestri...Saunder's Comprehensive Review for NCLEX-RN also refers to # of deliveries.


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