A pregnant woman in active labor is feeling lightheaded and nauseated after receiving epidural anesthesia. What should the nurse do first?

Placing the client in a 15-degree side-lying position is an appropriate initial action because it can help alleviate the symptoms of lightheadedness and nausea by improving venous return to the heart and increasing blood flow to the placenta. This position can also help prevent hypotension that can occur with epidural anesthesia, which may lead to decreased blood flow and oxygenation to both the mother and the fetus.

This intervention is particularly important in a pregnant woman who has just received an epidural, as the blockage of pain pathways can also affect sympathetic nervous system function and lead to vasodilation and hypotension. By positioning her to the side, the nurse enhances blood circulation, which can stabilize the patient’s condition effectively before any further interventions are pursued.

Other options, while relevant in care, may not address the immediate concern as effectively. For instance, administering intravenous fluids can help if fluid volume is low, but the side-lying position can provide more immediate relief. Monitoring the fetal heart rate is important, but ensuring the mother's stability should take precedence when symptoms like lightheadedness and nausea arise. Administering an antiemetic could assist with nausea but would not address the underlying issue of potentially decreased maternal blood pressure or venous return.