The client should first be moved from supine to left lateral. The intravenous flow rate should then be increased from 125 to 150 mL/hr. Utilizing a face mask, provide oxygen at a rate of 8 to 10 L/min. Finally, check the mother's blood pressure to see if the systolic reading is less than 100 mm Hg.
Epidural anesthesia's adverse effect of hypotension causes a reduction in placental perfusion and late decelerations on the fetal monitor. Repositioning the client is the first goal in order to promote venous return and reduce vena cava compression, which in turn increases placental perfusion.
Both giving oxygen and raising the flow rate are appropriate therapies, but none should take precedence over the other since they won't work until the vena cava's compression has been eased.
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