During labor a client who has been receiving epidural anesthesia has a sudden episode of severe nausea, and her skin becomes pale and clammy. What is the nurse's immediate reaction?

In this scenario, the client's sudden episode of severe nausea, accompanied by pale and clammy skin, suggests a potential complication related to the epidural anesthesia, such as hypotension or vasodilation. Turning the client on her side is a priority intervention because it helps to improve venous return and can alleviate pressure on major blood vessels like the inferior vena cava. This position change can reduce the risk of further hypotension and can immediately enhance the perfusion to vital organs, including the placenta.

While increasing IV fluids and administering medication for nausea may be necessary later, the most critical immediate step is to ensure the patient's safety by enhancing circulation and preventing further complications. Calling for assistance might be needed, but the priority is to take direct action to stabilize the patient’s condition first. Therefore, positioning her on her side is the most appropriate first response to manage her symptoms effectively.