The best time to teach non-pharmacologic pain control methods to an unprepared laboring woman is during which phase?

Choice A rationale

The 1-hour glucose tolerance test is typically performed between 24 and 28 weeks of gestation to screen for gestational diabetes. This screening involves measuring the client's blood glucose level one hour after consuming a 50-gram glucose load. A normal result is generally considered to be a blood glucose level below 130-140 mg/dL.

Choice B rationale

Rubella titer is usually assessed early in pregnancy, ideally during the first prenatal visit, to determine the woman's immunity to rubella. If the woman is not immune, vaccination is typically offered postpartum to prevent infection in subsequent pregnancies, as rubella infection during pregnancy can cause serious congenital defects.

Choice C rationale

Sexually transmitted disease testing is ideally conducted at the initial prenatal visit to identify and treat any infections early in pregnancy, reducing the risk of transmission to the fetus and other complications. While repeat testing may be indicated based on risk factors, it is not a routine test specifically scheduled for the 24-week appointment for all clients.

Choice D rationale

Group B Streptococcus (GBS) culture is typically performed later in pregnancy, usually between 35 and 37 weeks of gestation, to determine if the woman is colonized with GBS. This is important for intrapartum management to prevent neonatal GBS infection.

Choice A rationale

Edema, particularly peripheral edema, is a common clinical sign of preeclampsia. It results from fluid shifts due to increased vascular permeability and decreased plasma protein levels associated with the disease process.

Choice B rationale

Glycosuria, the presence of glucose in the urine, is not typically a symptom of preeclampsia. It is more commonly associated with gestational diabetes, a separate condition of pregnancy characterized by impaired glucose tolerance.

Choice C rationale

Proteinuria, the presence of significant amounts of protein in the urine (typically ≥300 mg in a 24-hour urine collection), is a hallmark sign of preeclampsia. It reflects glomerular endothelial damage and increased permeability.

Choice D rationale

Hypertension, defined as a blood pressure of ≥140/90 mmHg on two separate occasions at least 4 hours apart after 20 weeks of gestation, is a key diagnostic criterion for preeclampsia. It results from systemic vasoconstriction.