How should a nurse document the obstetrical history of a client who is pregnant for the fourth time with two full-term deliveries and one spontaneous abortion?

The documentation of a patient's obstetric history utilizes two terms, gravida and para. Gravida refers to the number of times a woman has been pregnant, regardless of the outcome, while para refers to the number of pregnancies that have reached viable gestational age (typically considered as 20 weeks), including live births.

In this case, the client is currently pregnant for the fourth time, making her gravida 4. The client has two full-term deliveries, which contribute to the para count, while the one spontaneous abortion does not count as a viable outcome. Therefore, the para remains at 2, as it only includes the successful deliveries.

This leads to the conclusion that the appropriate documentation for this client's obstetrical history is gravida 4 and para 2. Thus, it accurately captures her current pregnancy status and pregnancy history without including the spontaneous abortion in the para count.