What initial action should the nurse take when a patient in labor reports leaking small amounts of urine?

When a patient in labor reports leaking small amounts of urine, the nurse's initial action should be to test the patient's vaginal secretions with nitrazine paper. This test is crucial as it helps differentiate between urine and amniotic fluid that may have ruptured. The nitrazine paper changes color when it comes into contact with amniotic fluid due to its higher pH, which is typically more alkaline compared to urine.

Understanding the distinction is important because it informs the clinical approach following the assessment. If the fluid is indeed amniotic fluid, it indicates that the membranes have ruptured, which may require further monitoring and intervention. This step is essential for ensuring the safety of both the mother and the fetus.

While other actions, such as notifying the healthcare provider or performing a vaginal examination, may be appropriate after confirming the nature of the fluid, identifying whether the membranes have ruptured takes priority. Monitoring the fetal heart rate is important during labor as well, but addressing the patient's report of fluid leakage directly is the first step in ensuring that both the patient's and the baby's needs are met immediately.