Centro Escolar University – Malolos

Nursing Department
HEALTH ASSESSMENT LECTURE

Name: Erika Anne M. Cadawan Date: April 17, 2020

Section: BSN-STEM1A Score: ___________________

ASSESSMENT FOR PREGNANT WOMEN

A. Identify the GTPAL (10 points; 2 points each)

1. A 20 year old female is currently 8 weeks pregnant. She had a miscarriage at 12 weeks
gestation two years ago. She has no living children. What is her GTPAL?
- Her GTPAL is: G=2, T=0, P=0, A=1, L=0
2. A 26 year old female is currently 26 weeks pregnant. She had a miscarriage at 10 weeks
gestation five years ago. She has a three year old who was born at 39 weeks. What is her
GTPAL?
- Her GTPAL is: G=3, T=1, P=0, A=1, L=1
3. A 29 year old female is currently 9 weeks pregnant. She has no living children. Two years
ago she had 2 miscarriages at 10 and 12 weeks gestation. What is her GTPAL?
- Her GTPAL is: G=3, T=0, P=0, A=2, L=0
4. A 30 year old female is 25 weeks pregnant with twins. She has 5 living children. Four of the
5 children were born at 39 weeks gestation and one child was born at 27 weeks gestation.
Two years ago she had a miscarriage at 10 weeks gestation. What is her GTPAL?
- Her GTPAL is: G=7, T=4, P=1, A=1, L=5
5. A 35 year old female is currently pregnant with twins. She has 10 year old triplets who were
born at 32 weeks gestation, and a 16 year old who was born at 41 week gestation. Twelve
years ago she had a miscarriage at 19 weeks gestation. What is her GTPAL?
- Her GTPAL is: G=4, T=1, P=1, A=1, L=4

B. Compute for EDC or EDD using Naegele’s Rule. Show your computation. (10 points;
2 points each)

1. LMP: January 20, 2016

- ECD or EDD: January 20, 2016 – 3 months = October 20, 2015
October 20, 2015 + 7 days = October 27, 2015
October 27, 2015 + 1 year = October 27, 2016
2. LMP: March 14, 2016
- ECD or EDD: March 14, 2016 – 3 months = December 14, 2015
December 14, 2015 + 7 days = December 21, 2015
December 21, 2015 + 1 year = December 21, 2016
3. LMP: August 28, 2016
- ECD or EDD: August 28, 2016 – 3 months = May 28, 2016
May 28, 2016 + 7 days = June 4, 2016
June 4, 2016 + 1 year = June 4, 2017
4. LMP: August 15, 2016
- ECD or EDD: August 15, 2016 – 3 months = May 15, 2016
May 15, 2016 + 7 days = May 22, 2016
May 22, 2016 + 1 year = May 22, 2017
5. LMP: January 30, 2016
- ECD or EDD: January 30, 2016 – 3 months = October 30, 2015
October 30, 2015 + 7 days = November 6, 2015
November 6, 2015 + 1 year = November 6, 2016

C. Differentiate the 3, presumptive, probable and positive signs of pregnancy (10

points)
 Presumptive signs of maternity refers to signs and symptoms that may
match pregnancy signs and symptoms, however could after all be caused by
something else. One of these presumptive signs of maternity is that the
absence of a period. Whereas this can be a sign of maternity, missing a
period may result from things corresponding to illness or stress during a
woman's life, thus this can be not a reliable sign of suspected maternity.
 Probable signs of pregnancy are signs that indicate pregnancy the majority of
the time. However, there's still the possibility they'll be false or caused by one
thing other than pregnancy, like presumptive signs. A positive pregnancy test
could be a probable sign of pregnancy. However, in some instances,
pregnancy tests will offer off false positives for a variety of reasons, similar to
the urine being too diluted once the test is taken, or the directions not being
followed fully.
 Positive signs of pregnancy are signs that can't, beneath any circumstances,
be mistaken for alternative conditions, and are proof that pregnancy has
occurred. These signs embody fetal heart sounds by a Doppler within the
doctor's office, ultrasound detection of the fetus, or the movement of the fetus
felt by a doctor. These signs can't be brought on by the other condition.
There's no interpretation or "faking" the sound of a fetal heartbeat, or seeing a
fetus on an ultrasound screen.
D. Identify signs and symptoms of pregnancy according to: Presumptive, probable and
positive (20 points)

Presumptive Probable Positive

 Amenorrhea (no  Increased frequency  Fetal Heart

period) of urination Sounds
 Nausea — with or  Soft cervix  Ultrasound
without vomiting  Abdominal Scanning of the
 Breast bloating/enlargement Fetus
enlargement and  Mild uterine  Palpation of the
tenderness cramping/discomfort Entire Fetus
 Fatigue without bleeding  Palpation of Fetal
 Poor sleep  Increased skin
  Back pain pigmentation in the Movement
 Constipation face, stomach,  X-ray
 Food cravings and and/or areola  Actual Delivery of
aversions  Tender and swollen An Infant
 Mood changes or breasts/chest
"mood swings"  Nausea and Food
 Heartburn Aversions
 Nasal congestion  Mood changes
 Shortness of
breath
 Lightheadedness
 Elevated basal
body temperature
(BBT)
 Spider veins
 Reddening of the
palms

E. Discuss the different lie and presentation of the fetus.(10 points)

 Longitudinal lie: the fetus lies horizontally across the birth canal and
presents shoulder first. A cesarean delivery is done, unless the fetus is the
second in a set of twins. In such a case, the fetus may be turned to be
delivered through the vagina.
 Oblique lie: in an oblique lie there is an anatomical relationship in which the
fetal axis crosses the maternal axis at an angle other than a right angle. i.e.
no fetal presenting part is palpable in the lower pole and the head or the
breech is in an iliac fossa.
 Unstable lie: Refers to the frequent changing of fetal lie and presentation in
late pregnancy. (usually refers to pregnancies > 37 weeks)1. Lie. Refers to
the relationship between the longitudinal axis of the fetus and that of its
mother, which may be longitudinal, transverse or oblique.
 Transverse lie: is a sideways position. The baby has his head to one of his
mother's sides and the bottom across her abdomen at her other side.
 Anterior position: This position means the fetus's head is down in the pelvis,
facing the woman's back. The fetus's back will be facing the woman's belly.
This position means the fetus's head can be tucked in, allowing the top of it to
press down on the cervix, which encourages it to open during labor.
 Posterior position: When a baby is head-down but facing your abdomen,
she's said to be in the occiput posterior (OP) position – or posterior position,
for short. The term refers to the fact that the back of your baby's skull (the
occipital bone) is in the back (or posterior) of your pelvis.
 Shoulder presentation: The fetus is positioned normally (head first) for
delivery, but the fetus’s shoulder becomes lodged against the woman’s pubic
bone as the fetus’s head comes out. Consequently, the head is pulled back
 tightly against the vaginal opening. The baby cannot breathe because the
chest and umbilical cord are compressed by the birth canal. As a result,
oxygen levels in the baby’s blood decrease.
 Face presentation: The neck arches back so that the face presents first.
 Brow presentation: The neck is moderately arched so that the brow
presents first.
 Occiput or cephalic posterior position: Sometimes the baby is positioned
head down as it should be, but other times it is facing the mother's abdomen.
With the head in this position, the baby is looking at the ceiling. You may hear
this position nicknamed sunny-side-up.
 Breech position: The breech position is when the fetus remains with the
head up instead of down in the woman’s pelvis. There are different types of
breech position, including:
o Frank breech: When the baby's legs are folded flat up against his head
and his bottom is closest to the birth canal.
o Complete breech: When both of the baby's knees are bent and his feet
and bottom are closest to the birth canal.
o Footling breech: Sometimes, one or both of the baby's feet are pointed
down toward the birth canal. This increases the chances of the umbilical
cord slithering down into the mouth of the womb, cutting off blood supply
to the baby.