While reviewing prenatal records with a client and her partner, the nurse notes documentation in the medical record indicating that the client is a G2P0. However, the client denies a previous pregnancy. Which action by the nurse is appropriate?

Question

While reviewing prenatal records with a client and her partner, the nurse notes documentation in the medical record indicating that the client is a G2P0.  However, the client denies a previous pregnancy.  Which action by the nurse is appropriate?

Quizplus · Accepted Answer

When reviewing obstetric history, the GTPAL notation system gives the health care provider information about a client's past pregnancies. This notation may be shortened to gravida (ie, number of previous pregnancies) and para (ie, number of births after 20 weeks). For example, a G2P0 indicates 1 prior pregnancy ending before 20 weeks and 1 current pregnancy. The nurse should be cautious of discussing obstetric history with a client in front of the partner or family and not assume that others have knowledge of the client's past pregnancies. If there is a discrepancy between what the client discloses in the interview and the medical record, the information should be clarified when the client is alone to maintain confidentiality (Option C). (Option A) The nurse should not change information in the medical record until the information is clarified appropriately with the client. (Option B) Although the client's medical record indicates a previous pregnancy, it is not appropriate to ask if the pregnancy was an abortion or a miscarriage in front of the client's partner. (Option D) Explaining the need for accurate information is not appropriate at this time and does not assist with clarifying the client's obstetric history in a private manner. Educational objective: The nurse should be cautious of discussing a client's obstetric history in front of the client's partner or family to avoid breaching confidentiality. Clarification or further questioning about the client's history should take place when the client is alone.

While Reviewing Prenatal Records with a Client and Her Partner