The nurse should realize that the most common and potentially harmful maternal complication of epidural anesthesia is:

Choice A rationale
Placental insufficiency can cause late decelerations in fetal heart rate due to decreased blood flow, but it typically shows a gradual decrease rather than the abrupt patterns seen here.
Choice B rationale
Abruption usually presents with painful vaginal bleeding and a tender uterus, rather than specific changes in fetal heart rate patterns like those described in the question.
Choice C rationale
Head compression results in early decelerations, which appear as a mirror image of contractions, but these are not sudden drops in heart rate typically seen in cord compression.
Choice D rationale
Cord compression leads to variable decelerations characterized by sudden drops in fetal heart rate, caused by temporary reduction in oxygen flow to the fetus. This matches the tracing pattern described.

Choice A rationale
While iron-rich foods are important, the decrease in hematocrit is primarily due to hemodilution rather than inadequate iron intake. Hemodilution occurs as plasma volume increases more than red cell mass.
Choice B rationale
Hematocrit changes in pregnancy are typically not indicative of a serious problem but a normal physiological adaptation. Hemodilution reduces hematocrit without indicating a pathological condition.
Choice C rationale
During pregnancy, plasma volume increases by approximately 50%, while red cell mass increases by about 30%, leading to hemodilution. This physiological change results in a lower hematocrit value.
Choice D rationale
Although hematocrit decreases due to hemodilution, it does not mean that there is a deficiency in red blood cell production. It reflects the dilution effect of increased plasma volume during pregnancy.