A gravida client develops maternal hypotension following regional anesthesia. Which action should the nurse implement as the best initial step?

• A. Administer oxygen.
• B. Increase IV fluids.
• C. Place the client in a lateral position.
• D. Monitor fetal status.

Answer: (C)

When regional anesthesia causes maternal hypotension, the immediate issue is reduced venous return due to sympathetic blockade and, in late pregnancy, possible aortocaval compression. The most important first action is to position the laboring patient on her left side. This maneuver relieves pressure from the uterus on the inferior vena cava, improves venous return to the heart, and increases cardiac output, which helps raise blood pressure and improve placental perfusion quickly.

After repositioning, you can provide oxygen and assess the need for additional measures such as IV fluids or vasopressors as ordered. Fetal status monitoring remains important, but stabilizing the mother's circulation comes first to protect both mother and fetus.