The nurse is caring for a female client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission?
A. Regular diet
B. Skim milk
C. Nothing by mouth
D. Clear liquids
Correct Answer: C. Nothing by mouth
Shock and bleeding must be controlled before oral intake, so the client should receive nothing by mouth. When the bleeding is controlled, the diet is gradually increased, starting with ice chips and then clear liquids. In patients hospitalized for acute upper gastrointestinal bleeding due to an ulcer with high risk of rebleeding or with variceal bleeding, it is recommended to wait at least 48 h after endoscopic therapy before initiating oral or enteral feeding.
Option A: A regular diet is incorrect. Proton pump inhibitors (PPIs) are beneficial for both ulcer and non-ulcer diseases as they reduce the risk of re-bleeding by clot stabilization. Endoscopy should only be performed after hemodynamic stability has been achieved and should not be delayed by more than 24 hours.
Option B: Skim milk shouldn’t be given because it increases gastric acid production, which could prolong bleeding. Further research found that ingesting milk increases the production of stomach acid, which can worsen gastritis symptoms. Any relief gastritis sufferers experience after drinking a glass of milk is likely to be temporary; within a half-hour, symptoms are usually worse, not better.
Option D: A liquid diet is the first diet offered after bleeding and shock are controlled. They can be fed with clear liquids soon after endoscopy. Clear liquids provide the advantage that if the patient starts to bleed again, sedation and anesthesia can be given within two hours after the last ingestion
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