What is the appropriate action for a nurse caring for a client in active labor receiving epidural anesthesia?

Administering a bolus of lactated Ringer's 500 mL prior to the placement of an epidural is appropriate because it helps to prevent hypotension, a common side effect of epidural anesthesia. Epidural anesthesia can cause vasodilation, leading to decreased blood pressure. Providing a preload with IV fluids helps to maintain blood volume and can mitigate potential drops in blood pressure after the epidural is administered.

It is critical to ensure maternal hemodynamic stability for both the mother and the fetus during the labor process. Fluid administration before the epidural can create a more stable environment, which is particularly important for the fetus as well, since it can help with uteroplacental perfusion.

In contrast, while monitoring vital signs continuously during the procedure is important for patient safety, this action may come after the proactive measure of fluid administration. Similarly, obtaining informed consent is a necessary step in many procedures, but it generally occurs prior to the actual placement of the epidural, rather than as an immediate action during active labor with the epidural ongoing. Administering a bolus of normal saline may also be beneficial; however, lactated Ringer's is often preferred due to its electrolyte composition that better supports the physiologic needs during