A woman presents to the clinic in the first trimester of pregnancy.

She has three children living at home.

One of them was born prematurely at 34 weeks.

The other two were full-term at birth.

She has a history of one miscarriage.

How do you record her obstetric history on the chart using GTPAL format?

Choice A rationale

Support during labor has been shown to significantly decrease the perception of pain. Continuous presence of a supportive individual, such as a doula or partner, provides comfort, encouragement, and various coping mechanisms, which can physiologically reduce stress hormone release and enhance the body's natural pain-modulating systems, leading to a less painful experience.

Choice B rationale

A supportive presence during labor contributes to an improved overall experience for the client. The emotional, physical, and informational support provided can alleviate anxiety, empower the client, and foster a sense of control and confidence, leading to a more positive and satisfying childbirth experience, often with lasting beneficial psychological impacts.

Choice C rationale

Support during labor can contribute to better fetal outcomes by reducing maternal stress and anxiety. Lower maternal stress levels can lead to improved uterine blood flow and oxygenation to the fetus. Additionally, continuous support can lead to fewer interventions, such as operative deliveries, which are associated with potential risks to the fetus.

Choice D rationale

Research indicates that continuous support during labor is associated with improved client outcomes. This includes a reduced likelihood of medical interventions, such as epidural anesthesia, synthetic oxytocin for augmentation, and cesarean sections. Enhanced emotional well-being and reduced maternal stress hormones also contribute to a more positive physiological response during labor.

Choice E rationale

Support during labor is known to decrease, not increase, anxiety. The presence of a supportive individual provides reassurance, reduces fear of the unknown, and offers comfort. This contributes to a calm environment, which can physiologically mitigate the stress response, thereby lowering anxiety levels and promoting a more relaxed labor progression for the client.

Choice A rationale

Performing a testicular self-exam weekly is too frequent and unnecessary. The recommended frequency is monthly. While lying down might be acceptable, performing it after a warm shower is generally preferred due to muscle relaxation. Checking for pain is part of the examination, but the emphasis is on identifying changes rather than just pain.

Choice B rationale

Using fingertips and checking for pain are indeed components of the testicular self-exam; however, these are not the *most important* teaching points. The primary goal is to become familiar with the normal consistency and feel of the testicles to detect any subtle changes, not just to check for pain, which might only be present in symptomatic conditions.

Choice C rationale

This statement is incorrect and misleading. Testicular self-exams are recommended for *all* adolescent boys, regardless of family history of cancer. Early detection through regular self-examination significantly improves prognosis for testicular cancer, which can occur without any prior family history.

Choice D rationale

Performing the exam monthly after a warm shower is the most important teaching point. The warm shower relaxes the scrotal sac, making it easier to palpate the testicles and detect any abnormalities. Monthly performance ensures consistency and allows for early identification of any changes from the baseline normal.