A nurse is caring for a primigravida whose cervix is 2 cm dilated, 75% effaced, and the fetal presenting part is at +2 station.
The patient says to the nurse, “I want an epidural now.Why won’t someone give me an epidural?” Which response is most appropriate for the nurse to make?

he correct answer is choice B. Sufficient perfusion and circulation of the fetus.This is because the fetal heart rate is within the normal range of 110 to 160 beats per minute, and there is moderate beat-to-beat variability, which indicates a healthy nervous system.

Choice A is wrong because insufficient perfusion of the placenta would cause fetal distress and abnormal fetal heart rate patterns, such as late decelerations or minimal variability.

Choice C is wrong because maternal hypoxia would not directly affect the fetal heart rate, unless it leads to placental insufficiency or uterine hyperstimulation.

Choice D is wrong because fetal hypoxia would cause signs of fetal distress, such as tachycardia, bradycardia, or absent variability.

The correct answer is choice B: The risk of transplacental transmission of chlamydia between mother and baby is low.This means that the infection is unlikely to pass from the mother’s blood to the baby’s blood through the placenta.However, this does not mean that the infection is harmless for the baby.

Choice A is wrong because transmission of chlamydia usually occurs when the baby passes through the vagina.This can cause eye infections or pneumonia in the newborn.

Choice C is wrong because the baby has probably not developed antibodies to the chlamydia in utero.Antibodies are proteins that help fight infections, and they are usually passed from the mother to the baby through the placenta.However, chlamydia does not stimulate a strong antibody response in the mother, so there is little protection for the baby.

Choice D is wrong because the baby will not receive systemic treatment at birth to prevent a chlamydia infection.Systemic treatment means medication that affects the whole body, such as oral or intravenous antibiotics.The baby will only receive topical treatment, such as eye drops or ointment, to prevent eye infections.Normal ranges: Chlamydia infection is common among pregnant women, especially those under 25 years old or with risk factors such as multiple or new sexual partners.The prevalence of chlamydia among pregnant women in the United States ranges from 1% to 40%, depending on the population and screening methods.Chlamydia infection can be diagnosed by urine or swab tests, and treated with antibiotics such as azithromycin or doxycycline.Chlamydia screening is recommended for all pregnant women at their first prenatal visit and again in the third trimester if they are at high risk.