What is the priority nursing action before spinal anesthesia?

• A. IV fluid bolus (500-1000 mL)
• B. Administer antiemetic prophylaxis
• C. Place the patient in Trendelenburg position
• D. Prepare for cesarean delivery

Answer: (A)

Anticipating spinal anesthesia, the priority is maintaining circulating volume to prevent hypotension from the block. Spinal anesthesia causes sympathetic blockade, leading to vasodilation and reduced venous return, which can quickly drop blood pressure and compromise placental perfusion. Administering an IV fluid bolus beforehand helps sustain intravascular volume, supports blood pressure, and protects both mother and fetus during the procedure. While antiemetics and positioning can help with related symptoms, they don’t prevent the primary hemodynamic change as effectively, and preparing for cesarean isn’t the immediate pre-spinal action.