A patient involved in a motor vehicle crash presents with abdominal distension and LUQ pain. What is the first nursing action?

In the context of a patient presenting with abdominal distension and left upper quadrant (LUQ) pain following a motor vehicle crash, the appropriate first nursing action is to obtain type and cross for blood. This step is crucial because the mechanism of injury suggests a potential for internal bleeding or significant abdominal trauma, particularly involving organs such as the spleen or stomach that are located in the LUQ.

Identifying the patient's blood type and having compatible blood available is vital, especially if there is a need for a blood transfusion due to hemorrhage. In trauma cases, clinicians must prioritize interventions that will stabilize the patient's condition and prepare for potential emergency surgical interventions.

While other actions, such as administering pain medication or preparing for diagnostic imaging like a CT scan, might seem reasonable, they could delay necessary life-saving treatments. Inserting a nasogastric tube may also be indicated later, particularly if there is suspicion of gastrointestinal injury, but ensuring the patient has access to blood products is paramount in trauma care. This ensures that the healthcare team is ready to respond swiftly to complications that may arise from internal bleeding or shock, making the first action of obtaining type and cross for blood the most critical.