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A nurse is performing a vaginal examination on a client who is in labor and observes the umbilical cord protruding from the vagina. After calling for assistance, which of the following actions should the nurse take?

A. Place the client in Trendelenburg position
B. Push the cord back into the vagina
C. Apply gentle pressure to the presenting part
D. Administer tocolytic medication

User Wolendranh
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1 Answer

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Final answer:

When observing a protruding umbilical cord during a vaginal examination, a nurse should call for assistance and place the client in the Trendelenburg position to relieve pressure on the cord and maintain blood flow to the baby.

Step-by-step explanation:

When a nurse observes the umbilical cord protruding from the vagina during a vaginal examination, it is called cord prolapse. This is a serious obstetric emergency that requires immediate action. The nurse should first call for assistance and then take steps to relieve pressure on the cord. This can be done by placing the client in a knee-chest or Trendelenburg position, which helps to prevent further compression of the cord and maintain blood flow to the baby.

Option A: Place the client in Trendelenburg position

Option B: Pushing the cord back into the vagina is not recommended as it can cause further compression and compromise blood flow to the baby.

Option C: Applying gentle pressure to the presenting part does not address the issue of cord prolapse.

Option D: Administering tocolytic medication is not the appropriate intervention for cord prolapse.

User Mark Soric
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