A nurse detects pulsating tissue during a cervical examination in a laboring client. What is the most appropriate action?

When pulsating tissue is detected during a cervical examination in a laboring client, this finding is indicative of the presence of the umbilical cord accidentally slipping into the vaginal canal, also known as cord prolapse. In this situation, the most appropriate action is to leave the fingers in place and press the nurse call light. This is crucial because maintaining a steady position helps to relieve pressure from the cord, reducing the risk of compromised blood flow to the fetus.

By keeping the fingers in place, the nurse can create a barrier that may prevent further compression of the cord while awaiting assistance. Prompt notification of the healthcare team is critical in this scenario, as it allows for immediate intervention, which may include repositioning the mother or preparing for an emergency cesarean section if needed.

Other actions, such as moving the client to a semi-Fowler's position or asking the client to push, could exacerbate the situation by increasing pressure on the cord. Leaving the client to call the provider without maintaining fetal stability is likewise inappropriate, as it could lead to further complications. Thus, pressing the nurse call light while keeping the fingers in place is the most effective and immediate response to ensure the safety of both the mother and the fetus.