What is the next step after initiating fluid resuscitation in a construction worker with lower abdominal pain?

After initiating fluid resuscitation in a patient presenting with lower abdominal pain, particularly in a trauma setting, the next appropriate step is to perform a FAST (Focused Assessment with Sonography for Trauma) exam. This is a rapid bedside ultrasonography technique that helps assess the presence of free fluid, which may indicate internal bleeding or organ injury.

In trauma cases, especially for a construction worker who might have sustained significant abdominal trauma, identifying potential hemoperitoneum is crucial for determining the need for further surgical intervention. The FAST exam can quickly guide the clinical decision-making process by revealing free fluid in the abdominal cavity, thus helping prioritize further management.

While a detailed neurological exam, rectal exam, and cervical c-spine x-ray may all be important in other scenarios or situations involving specific symptoms, they are not immediately indicated following fluid resuscitation in the context of suspected abdominal trauma. The priority remains on evaluating and managing any potential internal injuries, making the FAST exam the most logical next step.