How should the nurse document the pregnancy history of a client who has had a 4-year-old child, experienced a miscarriage, and is currently pregnant with twins?

The correct answer is reflected in the acronym used for documenting obstetrical history: GTPAL, where G stands for the number of pregnancies, T for term deliveries, P for preterm deliveries, A for abortions (miscarriages), and L for living children.

In this case, the woman has a total of three pregnancies: one successful full-term pregnancy resulting in her 4-year-old child, one miscarriage (considered an abortion), and the current pregnancy with twins.

Breaking it down:

• G (Gravida): This counts all pregnancies, including the current one, so it is 3 (the child, miscarriage, and current twin pregnancy).

• T (Term): This counts pregnancies delivered at term (37 weeks or more); the woman has had one (the 4-year-old child).

• P (Preterm): There have been no deliveries before 37 weeks, which makes this 0.

• A (Abortions): This includes any miscarriages or elective abortions. Since she experienced one miscarriage, this is recorded as 1.

• L (Living children): She has one living child, which is the 4-year-old.

This results in the documentation of