Upper GI Bleed
A 61-year-old client has taken ibuprofen several times daily for knee pain. The client vomits a large amount of bright red blood at home and is brought to the emergency department.
Recognize cues
Vital signs: BP 88/54, HR 126, RR 24, SpO2 96%, temperature 36.5 C. The client is pale and lightheaded, hemoglobin is 7.6 g/dL, BUN 38 mg/dL, and there is a second episode of hematemesis in the department.
Which finding requires the most immediate follow-up?
Take action
The provider orders two large-bore IVs, isotonic fluid resuscitation, type and crossmatch, an IV proton pump inhibitor, NPO status, and an urgent endoscopy.
Which two actions should the nurse take first?
Evaluate outcomes
After transfusion and endoscopic clipping of a gastric ulcer: BP 122/72, HR 82, hemoglobin 9.8 g/dL and stable on repeat, no further hematemesis, and urine output is 40 mL per hour.
Which finding best indicates the treatment is working?
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