What is the first assessment a nurse should perform for a primigravida in her third trimester with acute abdominal pain?

In a scenario where a primigravida in her third trimester presents with acute abdominal pain, the priority assessment is to auscultate for fetal heart tones. This action is crucial because it provides immediate information about the well-being of the fetus. In the third trimester, assessing fetal heart tones helps determine if the fetus is in distress or if there are any signs of complications such as placental abruption or fetal hypoxia.

By checking the fetal heart tones, the nurse can quickly evaluate the fetal status, which is critical in guiding further interventions. If the fetal heart rate is abnormal, it may prompt more urgent actions like notifying the healthcare provider or preparing for further monitoring or interventions.

While checking vital signs, measuring fundal height, and palpating the abdomen for rigidity are all important assessments, they follow the initial evaluation of fetal heart tones in a situation where fetal well-being is the primary concern. The acute abdominal pain in a pregnant woman can indicate potential complications that directly impact the fetus, making the assessment of fetal heart tones the most immediate priority.