A nurse is assisting with the care of a client in active labor. The nurse observes clear fluid and a loop of pulsating umbilical cord outside the client's vagina. Which of the following actions should the nurse perform first?

A. Presentation, latent phase, powers, position and attitude. While "presentation," "powers," and "position" are relevant, the "latent phase" is a stage of labor, not a factor that affects the labor process. "Attitude" refers to the fetal posture but does not cover the entire process.

B. Passenger, passageway, powers, position and psychological response: These five factors are key components that affect labor and birth: Passenger: The fetus and placenta. Passageway: The birth canal. Powers: The contractions. Position: The mother’s position during labor. Psychological response: The mother’s emotional state during labor.

C. Passenger, presentation, lie, attitude and station: These terms describe aspects of the fetus's position and movement, but they do not encompass all the factors affecting labor.

D. Passageway, presentation, powers, contractions and position: This is close, but "psychological response" is missing, which is one of the essential components affecting labor.

A. Check the fluid with Nitrazine paper. While this test can confirm if the membranes have ruptured, assessing the fetal heart rate (FHR) is more critical to ensure that there is no fetal distress due to umbilical cord prolapse.

B. Assess the FHR. After suspected rupture of membranes, the priority is to assess the fetal heart rate to check for potential complications like umbilical cord prolapse, which can cause fetal distress.

C. Note the color of the fluid. Assessing the color of the fluid is important, especially if meconium is present, but it is secondary to ensuring fetal well-being by assessing the FHR first.

D. Notify the health care provider. The provider should be notified, but the first action should be to assess the fetal heart rate to check for signs of distress.