What complication is the nurse most concerned about when a client is receiving an epidural during labor?

When a client receives an epidural during labor, urinary retention is a significant concern. Epidural anesthesia can lead to decreased sensory and motor function in the lower body, affecting the client's ability to detect the urge to void. This can result in urinary retention, which can complicate the labor process and lead to potential bladder distension or infection if not addressed.

The mechanism behind urinary retention involves the impact of the epidural on the nerves that control bladder function. As the anesthetic numbs the lower body, the normal reflexes that trigger the urge to urinate may be diminished, making it difficult for the client to recognize when they need to go. Monitoring is essential, and if urinary retention occurs, interventions such as catheterization may be necessary to ensure bladder health and comfort during labor.

Other concerns, such as nausea and vomiting, urinary incontinence, and severe back pain, can occur but are generally not as directly linked to the functional impact of epidural anesthesia on bladder control as urinary retention is.