A nurse is caring for a client who is in active labor and requesting an epidural. Which of the following actions should the nurse take?

Choice A rationale Oxygen is typically administered for fetal distress or maternal hypoxemia, not routinely for pain management or epidural preparation. The priority before an epidural is often to stabilize maternal blood pressure, as the procedure frequently causes vasodilation and subsequent hypotension due to sympathetic blockade. Choice B rationale A key side effect of epidural anesthesia is hypotension caused by peripheral vasodilation from sympathetic nerve blockade. Administering a pre-procedure intravenous (IV) fluid bolus (e.g., normal saline or lactated Ringer's) increases circulating blood volume, effectively helping to minimize the risk and severity of this common hemodynamic change. Choice C rationale Ondansetron is a serotonin antagonist primarily used to treat nausea and vomiting. While sometimes used for these side effects in labor, it is not the priority action before an epidural. Fluid administration to prevent hypotension is the critical immediate prophylactic measure required for maternal safety. Choice D rationale While epidurals are commonly placed in the active phase of labor (usually 4 to 5 cm dilation or more), delaying the procedure until 7 cm is an outdated and arbitrary practice. The timing is determined by maternal request, pain level, and clinical assessment, not a rigid cervical dilation number, as effective pain relief is crucial.