Following a mitral valve replacement, the client suddenly begins to show a large amount of blood on the surgical dressing while in the postanesthesia care unit (PACU). Which intervention should the nurse implement first?

A. Apply topical fibrin directly to the incision: Topical fibrin application is a provider-initiated intervention. It is not within the nurse’s scope to apply this independently in the PACU setting and should not delay immediate nursing actions to control visible bleeding. B. Reinforce the incisional dressing: A sudden large amount of blood on the surgical dressing indicates potential hemorrhage. Reinforcing the dressing is the first nursing action to help control bleeding, prevent further blood loss, and allow assessment of bleeding progression while the provider is being notified. C. Increase the intravenous fluid rate: Increasing IV fluids may help manage hypotension related to blood loss but administering fluids without first attempting to control or quantify bleeding may worsen outcomes if bleeding is uncontrolled. D. Obtain samples for coagulation studies: Laboratory evaluation is necessary to assess for coagulopathy but is not the immediate priority. Stabilizing the client by addressing active bleeding takes precedence, after which labs can guide further treatment decisions.