A nurse is caring for a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse perform first?

A. Place the client in knee-chest position: The knee-chest position helps shift the fetus away from the cord, reducing compression. However, it is a supportive measure and should follow immediate manual relief of pressure to protect fetal oxygenation. B. Prepare the client for an immediate birth: Delivery may be necessary, especially by emergency cesarean section, but this is not the first action. Immediate intervention to relieve cord compression takes priority before surgical preparation. C. Cover the cord with a sterile, moist saline dressing: Keeping the cord moist helps prevent vasospasm and tissue damage, but this action is secondary to relieving cord pressure. It is supportive, not the first critical intervention. D. Insert a gloved hand into the vagina to relieve pressure on the cord: This is the priority action to prevent cord compression, which can quickly lead to fetal hypoxia or death. Manual elevation of the presenting part reduces pressure and maintains perfusion until delivery.