Amultigravid client in active labor at term suddenly sits up and says, "i cannot breathe! my chest hurts really bad! " the client's skin begins to turn a dusky gray color. after calling for assistance, which actionshould the nurse take next?

There are choices for this question namely:

a. Administer oxygen by face mask

b. Begin cardiopulmonary resuscitation

c. Administer intravenous oxytocin

d. Obtain a prescription for intravenous fibrinogen

The correct answer is “administer oxygen by face mask”. Still following the ABC of emergency medicine where we assess first the airway then the breathing then the circulation. Oxygen should immediately be administered first in an obstetric patient presenting with respiratory distress and cyanosis. If the patient goes into a cardiopulmonary arrest then cardiopulmonary resuscitation should be done. Intravenous oxytocin and intravenous fibrinogen may only have a role if there is a definitive diagnosis of the patient’s condition (i.e. amniotic fluid embolism).

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