A nurse is caring for a client who is dilated to 10 cm and pushing. Which of the following pain-management measures should the nurse identify as a safe option for the client?

A. Butorphanol (an opioid agonist-antagonist) can cause respiratory depression in the newborn if administered close to delivery; not safe during second-stage labor. B. Naloxone is not a pain management drug, it reverses opioid effects and would not provide analgesia. C. Spinal anesthesia is typically used for cesarean delivery, not for a woman already pushing in the second stage of labor. D. A pudendal block provides local perineal anesthesia for the late second stage of labor, episiotomy, or delivery. It does not affect maternal consciousness or fetal status, making it safe during pushing.