A client in labor receives an epidural block. What intervention should the nurse implement first?

• A. Encourage oral fluids.
• B. Assess contractions.
• C. Monitor blood pressure.
• D. Obtain a radial pulse.

Answer: (C)

The main idea is that epidural anesthesia can cause a drop in blood pressure because of sympathetic nerve blockade, and this hypotension can reduce placental blood flow and harm the fetus. Because preventing or catching maternal hypotension early is essential for both mom and baby, the first step is to monitor the mother’s blood pressure continuously. This allows rapid recognition of a decline and prompt intervention to restore perfusion, such as placing the patient in the left lateral position to improve venous return, ensuring adequate IV fluid administration, and administering a vasopressor as ordered if needed. While other tasks like assessing contractions or checking a pulse are important, they don’t address the immediate risk to maternal and fetal well-being in this situation.