Pathophysiology
A client has dark, tarry stools. The nurse recognizes this indicates bleeding in which area?
Upper GI tract
A nurse reviews lab results for a client with GI bleeding. Which lab finding indicates hypovolemia?
A. Increased hematocrit
B. Decreased hemoglobin
C. Elevated bilirubin
D. Low potassium
A client with cirrhosis has vomited bright red blood. The nurse suspects:
A. Esophageal varices
B. Gastritis
C. Diverticulosis
D. Peptic ulcer disease
The nurse caring for a client with GI bleeding should first
Assess vital signs for hypovolemic shock
The nurse teaches a client with GERD and hiatal hernia to avoid which behavior?
Lying flat immediately after eating
A client with a sliding hiatal hernia reports heartburn and regurgitation. The nurse understands these symptoms occur due to
Reflux of gastric contents in the esophagus
Which diagnostic test best identifies the source of an upper GI bleed?
Esophagogastroduodenoscopy (EGD)
A nurse reviews the health history of a client at risk for GI bleeding. Which factor requires immediate intervention?
A. History of smoking and alcohol use
B. Low-fiber diet
C. Sedentary lifestyle
D. History of constipation
A nurse is caring for a client receiving packed red blood cells for GI bleeding. Which finding indicates a positive response to treatment?
A. Heart rate decreases from 118 to 88 bpm
B. Blood pressure drops from 118/72 to 100/64 mmHg
C. Urine output decreases
D. Skin becomes pale and cool
The nurse instructs a client with a history of peptic ulcer disease to avoid which medication?
Ibuprofen (NSAIDs)
Which of the following conditions most likely causes melena?
Gastric ulcers
A nurse assesses a client with a suspected lower GI bleed. Which finding is most consistent?
Bright, red stool
A nurse is reviewing risk factors for upper GI bleeding with a nursing student. Which of the following conditions should be included?
Peptic Ulcer Disease
Which medication helps prevent recurrent bleeding from peptic ulcers?
Proton pump inhibitor
The nurse teaches a client about dietary changes for GI bleeding prevention. Which food should be limited?
Alcohol and caffeine.
A client with a long history of alcohol use presents with hematemesis. Which pathophysiological process most likely caused this?
A. Gastric outlet obstruction
B. Variceal rupture from portal hypertension
C. Reduced gastric acid secretion
D. Duodenal ulcer perforation
A client with an upper GI bleed becomes pale, diaphoretic, and restless. Which nursing action is priority?
A. Assess level of consciousness
B. Obtain a stool specimen
C. Monitor bowel sounds
D. Check capillary refill
Which client is at greatest risk for developing a gastric ulcer leading to GI bleeding?
A. 34-year-old taking oral contraceptives
B. 55-year-old taking daily aspirin for cardiac prevention
C. 20-year-old vegetarian
D. 40-year-old with lactose intolerance
A nurse administers pantoprazole to a client with GI bleeding.
Decrease gastric acid secretion
A nurse is reinforcing teaching about medication safety to a client who had a recent GI bleed and takes multiple prescriptions. Which statement requires intervention?
A. “I’ll always tell my provider before taking any new herbal supplements.”
B. “I’ll check with my provider before using aspirin or ibuprofen.”
C. “I’ll take my anticoagulant at the same time every day without missing a dose.”
D. “I’ll use acetaminophen for pain instead of NSAIDs.”
Bleeding that has been exposed to gastric acid
A client with suspected upper GI bleeding reports feeling dizzy after standing up. Which follow-up assessment is the nurse’s priority?
Check orthostatic vital signs
A nurse is caring for a client with chronic NSAID use. Which explanation best describes how NSAIDs contribute to GI bleeding?
A. They increase gastric mucus production
B. They inhibit prostaglandin synthesis, reducing mucosal protection
C. They stimulate gastric acid secretion
D. They increase lower esophageal sphincter tone
The provider prescribes an NG tube for a client with upper GI bleeding. What is the primary purpose of this intervention?
A. Remove gastric contents and assess for ongoing bleeding
B. Provide enteral nutrition
C. Relieve constipation
D. Administer oral medications
A nurse is teaching a client who had a recent upper GI bleed related to peptic ulcer disease about diet. Which instruction should the nurse include?
A. “Eat small, frequent meals throughout the day.”
B. “Avoid foods that are high in protein.”
C. “Drink carbonated beverages between meals.”
D. “Choose spicy foods to promote digestion.”