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

A. "This medication can cause nausea and drowsiness.": Gastrointestinal upset, including nausea, and central nervous system effects such as drowsiness or mild tremor are common early adverse effects of lithium. Clients should be monitored for symptom severity and reassured that these effects often diminish over time.

B. "You will be placed on a low-sodium diet while taking this medication": Lithium excretion is highly dependent on sodium levels; however, clients are advised to maintain a consistent, adequate sodium intake rather than restricting sodium. A low-sodium diet can increase lithium retention and risk toxicity.

C. "It will take at least a week before this medication reaches a therapeutic level.": Lithium requires several days to reach a steady-state concentration in the blood. Clients and caregivers should understand that therapeutic effects on mood stabilization may not be immediate, and monitoring serum levels is necessary.

D. "This medication can cause weight gain.": Weight gain is a recognized long-term adverse effect of lithium therapy, likely related to metabolic changes and fluid retention. Clients should be counseled on healthy diet and activity to help mitigate this effect.

E. "Blurred vision is an expected adverse effect of this medication": Blurred vision is not an expected or common side effect of lithium. If it occurs, it may indicate toxicity or another ophthalmologic issue, requiring immediate evaluation.

A. Monitor the client for hypertension: Epidural anesthesia commonly causes hypotension rather than hypertension due to sympathetic blockade and vasodilation. Continuous monitoring is essential, but the nurse focuses on identifying and managing hypotension.

B. Decrease the maintenance infusion rate of IV fluid: IV fluids are often administered before and during epidural placement to prevent hypotension. Reducing the infusion rate could worsen hypotension and compromise maternal and fetal perfusion.

C. Have protamine sulfate available at the bedside: Protamine sulfate is used to reverse heparin anticoagulation. It is not relevant to epidural administration and does not address the common risks associated with epidural anesthesia.

D. Reposition the client side-to-side each hour: Repositioning the client promotes maternal comfort, prevents pressure injury, and improves uteroplacental perfusion. Side-to-side positioning is recommended to avoid aortocaval compression and maintain adequate fetal oxygenation during labor.