The nurse is performing a vaginal assessment on a patient in labor and notices the umbilical cord protruding from the vagina. What is the priority nursing action with this finding?

A. Administering oxygen via a nonrebreather mask is incorrect as the priority action. Although oxygen can improve fetal oxygenation, it does not directly relieve compression of the umbilical cord, which is the immediate, life-threatening issue in a prolapsed cord. Oxygen may be used after cord compression is relieved, but it is not the first intervention. B. Placing a rolled towel beneath one of the client’s hips is incorrect because this action alone is insufficient to relieve pressure on the umbilical cord. While positioning such as Trendelenburg or knee-chest may help reduce cord compression, the most immediate and effective intervention is manual elevation of the presenting part. C. Applying internal upward pressure to the presenting part using two gloved fingers is correct because this action immediately relieves pressure on the prolapsed umbilical cord, restoring fetal blood flow and oxygenation. The nurse must maintain this pressure continuously until the patient is taken for emergency delivery, usually by cesarean section. This is the highest priority life-saving intervention. D. Increasing the IV infusion rate to provide a fluid bolus is incorrect because fluids do not address the mechanical compression of the umbilical cord. Although IV fluids may be part of overall management, they do not correct the acute cause of fetal hypoxia in cord prolapse.