After a client delivers and saturates a perineal pad in 15 minutes, which action should a nurse take first?

When a client saturates a perineal pad in a short period following delivery, this can be a sign of postpartum hemorrhage or significant bleeding. The nurse's priority in this scenario is to assess and intervene to ensure the safety and stability of the client.

Massaging the fundus is critical because a firm, contracted uterus helps control bleeding. If the uterus is boggy or atonic, it can lead to increased blood loss, and gentle but firm massage can help stimulate uterine contraction and minimize the risk of hemorrhage. This action should be taken immediately in response to the saturation of the pad to assess the condition of the uterus and control any bleeding.

Other options, while important in their own right, do not take precedence in this urgent situation. Administering pain medication may be necessary later, but it does not address the immediate concern of potential hemorrhage. Dimming the lights can help create a calming environment but also does not address the urgent need to assess and manage potential bleeding. Notifying the healthcare provider is critical for further management, but the nurse must first take immediate action to control the bleeding by assessing the fundal tone. Therefore, massaging the fundus is the most appropriate and urgent first action.