Your pregnant patient complains of hemorrhoids. On physical examination, vital signs are: temperature 98.6°F, pulse 80 beats/min, respirations 14 breaths/min, blood pressure 110/60. The heart has a regular rate and rhythm, no S3, no murmurs. Lungs are clear to auscultation. Abdominal examination is negative. Uterus fundus is at the umbilicus. Ankles show +1/4 bilateral ankle nonpitting edema. Dorsalis pedis pulses + 2/4 bilaterally. Rectal exam: + external hemorrhoid. Urine dipstick is negative for protein. The clinician should:
A) Explain to the patient to lie in a left lateral recumbent position at night
B) Refer the patient to an obstetric physician for a diuretic prescription
C) Obtain 24-hour urine for protein
D) Obtain HbA1c and fasting serum glucose
Correct Answer:
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