What should a nurse check for after a patient's membranes have ruptured?

After a patient's membranes have ruptured, one critical assessment a nurse should perform is checking for a prolapsed umbilical cord. When the membranes rupture, especially if it occurs before the onset of labor or during early labor, there is a risk that the umbilical cord could slip down into the vaginal canal ahead of the presenting part of the fetus. This can compromise fetal circulation and oxygenation, making it an urgent situation requiring immediate intervention.

Monitoring for a prolapsed cord involves assessing the position and presentation of the fetus, and feeling for any visible or palpable cord in the vaginal canal. If a prolapse occurs, it may be accompanied by changes in the fetal heart rate, which can indicate distress. The assessment for this condition is vital to prevent potential fetal complications. Although signs of infection, fetal heart rate, and uterine contractions are important assessments following membrane rupture, the direct risk of a prolapsed cord takes precedence in this scenario, making it a critical focus for the nurse’s assessment.