Gastrointestinal System Disorders Q 77

---

A patient has an acute upper GI hemorrhage. Your interventions include:

  

    A. Treating hypovolemia.

    B. Treating hypervolemia.

    C. Controlling the bleeding source.

    D. Treating shock and diagnosing the bleeding source.

    

    

Correct Answer: A. Treating hypovolemia.

---

A patient with an acute upper GI hemorrhage must be treated for hypovolemic and hemorrhagic shock. Monitor patient’s vital signs, especially BP and HR. Look for signs of orthostatic hypotension. Hypotension and tachycardia are initial compensatory mechanisms usually noted with bleeding. Orthostasis (a drip of 20 mm Hg in systolic BP or 10 mm Hg in diastolic BP when changing from supine to sitting position) indicates reduced circulating fluids.

---

Option B: Educate the patient and family members about signs of bleeding that need to be reported to a health care provider. Early evaluation and treatment of bleeding by a health care provider reduce the risk for complications from blood loss.

Option C: Controlling the bleeding may require surgery or intensive medical treatment. Tell the family members to be active in decision-making about the treatment of the patient at risk for bleeding. Active participation encourages a fuller understanding of the rationale and compliance with the treatment.

Option D: Inform the patient to check the color and consistency of stools. Bright red blood in the stools is an indicator of lower gastrointestinal bleeding. A stool that has a dark greenish-black color and a tarry consistency is linked with upper gastrointestinal bleeding.

---