A nurse is assisting in the care of a client who is 3 hours postpartum and reports complete saturation of their perineal pad in the past 30 minutes. Which of the following actions is the highest priority?

(A) Assist the client to empty her bladder:
Emptying the bladder is an essential intervention, especially in laboring women with epidural anesthesia, as a full bladder can contribute to hypotension. However, in this scenario, the priority is to address the hypotension directly with fluid administration. After stabilizing the client's blood pressure, assisting with bladder emptying would be appropriate.

(B) Place the client in knee-chest position:
The knee-chest position is not typically indicated for managing hypotension. While this position can increase venous return to the heart and potentially increase blood pressure, it is not the initial intervention for hypotension associated with epidural anesthesia. Intravenous fluid administration is the primary intervention to increase blood pressure in this situation.

(C) Administer methylergonovine IM:
Methylergonovine is a medication used to prevent or treat postpartum hemorrhage by causing uterine contractions. It is not indicated for the management of hypotension associated with epidural anesthesia during labor. Administering methylergonovine in this situation could potentially exacerbate hypotension and should be avoided.

(D) Give a bolus of lactated Ringer's:
The client's blood pressure is low (80/40 mm Hg), indicating hypotension. Hypotension can be a common side effect of epidural anesthesia during labor. Administering a bolus of intravenous fluids, such as lactated Ringer's solution, is the initial intervention to address hypotension. Fluid administration helps increase intravascular volume, improving blood pressure and perfusion to vital organs.

(A) Ask a parent to state the newborn's date of birth:
While asking a parent to state the newborn's date of birth may seem like a reasonable step, it relies on the parent's memory and verbal confirmation, which may not always be accurate. It's possible for a parent to forget or provide incorrect information, leading to potential identification errors.

(B) Check the newborn's footprint sheet with the medical record:
Footprint identification is a common practice in hospitals, but it may not always be feasible or practical during routine newborn transport to parents. Additionally, relying solely on footprints for identification may not be as reliable as comparing identification bands, as footprints can smudge or be difficult to match accurately.

(C) Request a parent to verify the newborn's name:
Asking a parent to verify the newborn's name relies on verbal confirmation, similar to option A. While it may provide some level of reassurance, it is not as reliable as comparing identification bands to confirm identity. Additionally, newborns may not yet have been formally named at the time of transport.

(D) Compare numbers on the newborn's band to the parent's band:
Comparing the identification numbers on the newborn's identification band with those on the parent's identification band is the most reliable method to confirm the newborn's identity. This process ensures that the newborn is matched with the correct parent(s) before handing over the infant. It helps prevent instances of newborn mix-up or abduction.