Nursing Interventions and Management

• Identify prolapsed cord and provide immediate intervention.
• Assess a laboring client often if the fetus is preterm or small for gestational age, if the fetal presenting part is not engaged, and if the membranes are ruptured.
• Periodically evaluate FHR, especially right after rupture of membranes (spontaneous or surgical), and again in 5 to 10 minutes.
• If prolapsed cord is identified, notify the physician and prepare for emergency cesarean birth.
• Using sterile gloved hand, insert 2 fingers into vagina, place finger on either side of cord, lift head from cord to stop compression.
• Reposition client knee-chest or Trendelenburg.
• Use warm, sterile saline soaked towel on visible cord to prevent cord drying up.
• Administer oxygen by face mask at 8 to 10 L/min as ordered.
• Start IV infusion or increase rate as ordered to maintain hydration and blood volume.
• Monitor maternal vital signs and FHR continuously until delivery.

Provide emotional support and reassurance to client and family.