A 55-year-old male patient presents to the emergency department with complaints of acute gastrointestinal (GI) bleeding. The patient reports passing black, tarry stools and experiencing dizziness and weakness. On physical examination, he is pale and diaphoretic.
Which of the following are the most appropriate initial nursing interventions for this patient? (Select all that apply)
Administer IV fluids
Prepare for possible blood transfusion
Monitor hemoglobin and hematocrit levels
Administer a proton pump inhibitor (PPI)
Administer oral iron supplements to address anemia
Correct Answer : A,B,C,D
A. Administer IV fluids: The patient is hypotensive (blood pressure 88/54 mmHg) and tachycardic (heart rate 115 bpm), indicating possible hypovolemic shock due to blood loss. Administering IV fluids will help to stabilize blood pressure.
B. Prepare for possible blood transfusion: The patient's hemoglobin level is critically low (6.5 g/dL), indicating significant blood loss and severe anemia. Preparing for a blood transfusion is crucial to correct the anemia.
C. Monitor hemoglobin and hematocrit levels: Continuous monitoring of hemoglobin and hematocrit levels is vital to assess the severity of the patient's anemia and response to treatment, guiding further interventions.
D. Administer a proton pump inhibitor (PPI): PPIs can help reduce gastric acid secretion, which may help control bleeding from peptic ulcers, a common cause of upper GI bleeding.
E. Administer oral iron supplements to address anemia: Oral iron supplements are typically used for long-term management of iron deficiency anemia but are not effective for immediate correction of severe anemia, particularly in an acute setting with ongoing blood loss.
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Related Questions
Correct Answer is B
Explanation
A. I should avoid alcohol completely to prevent another episode of pancreatitis: This is correct advice, as alcohol is a common cause of pancreatitis and should be avoided.
B. I can resume my high-fat diet once my symptoms improve. A high-fat diet can trigger another episode of pancreatitis, as fat stimulates pancreatic enzymes that can exacerbate the condition. The patient should follow a low-fat diet.
C. I should take my prescribed medications as directed to manage my symptoms: This statement is appropriate and reflects adherence to the treatment plan.
D. I need to follow up with my healthcare provider regularly to monitor my condition: This is also correct, as regular monitoring is essential to managing pancreatitis.
Correct Answer is A
Explanation
A. Dumping Syndrome: Dumping syndrome is a common complication following gastrectomy, where food moves too quickly from the stomach to the small intestine. Symptoms such as weakness, dizziness, and sweating, particularly after meals, are characteristic of this condition.
B. Peptic Ulcer Disease: While this can occur after gastrectomy, it typically presents with epigastric pain rather than weakness and dizziness after eating.
C. Gastroesophageal Reflux Disease (GERD): GERD typically presents with heartburn and acid regurgitation, not the postprandial weakness and sweating seen in dumping syndrome.
D. Irritable Bowel Syndrome (IBS): IBS symptoms usually include bloating, abdominal discomfort, and altered bowel habits, which are different from the described symptoms.
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