A nurse is caring for a client who is experiencing an amniotic fluid embolism during labor. Which of the following actions should the nurse take?

Choice A rationale Fundal massage is the primary intervention for uterine atony and postpartum hemorrhage to stimulate uterine contraction and tamponade bleeding. However, an amniotic fluid embolism (AFE) is characterized by sudden cardiopulmonary collapse, hypoxia, and coagulopathy, where fundal massage is irrelevant to the underlying pathology. Choice B rationale AFE involves the sudden entry of amniotic fluid into the maternal circulation, triggering a massive anaphylactoid reaction, acute respiratory distress, and severe refractory hypotension, leading to cardiac and respiratory arrest. Initiating cardiopulmonary resuscitation (CPR) is often immediately required to support life functions. Choice C rationale Assisting the client to empty their bladder may be beneficial during labor to allow the fetal head to descend, but it is not a priority intervention for the life-threatening, acute physiological crisis of an AFE. The immediate focus must be on optimizing oxygenation, circulation, and treating the underlying shock and coagulopathy. Choice D rationale AFE causes severe pulmonary vasoconstriction and acute respiratory distress, leading to profound hypoxemia. Applying oxygen at 2 L/min via nasal cannula is insufficient for this level of respiratory compromise; the client requires high-flow oxygen, often nonrebreather mask or mechanical ventilation, to maintain adequate arterial oxygen saturation.