A primigravid client in active labor has just received an epidural block. After administration, the nurse should assess for:

• A. Hypotension.
• B. Nausea and vomiting.
• C. Hypertension.
• D. Hyperthermia.

Answer: (C)

Epidural anesthesia can cause significant hemodynamic changes because the sympathetic nerves in the thoracic-to-lumbar region are blocked. This blockade leads to systemic vasodilation and venous pooling, especially in the lower body, which reduces venous return to the heart and lowers maternal blood pressure. The most important thing to monitor right after administering an epidural is blood pressure, since hypotension can compromise uteroplacental perfusion and potentially affect the fetus. You’ll often see symptoms like dizziness or lightheadedness, and nausea can accompany the drop in blood pressure. Management centers on increasing intravascular volume with IV fluids, positioning the patient to maximize venous return (commonly on the left side to reduce aortocaval compression), and using vasopressors as ordered (such as phenylephrine or ephedrine) with continuous BP monitoring. Hypertension and hyperthermia are not typical immediate concerns from an epidural block, though fever can occur in some cases and nausea may arise as a secondary symptom to hypotension.