A 60-year-old patient with a history of peptic ulcer disease is admitted to the hospital with complaints of coffee-ground emesis and melena. What is the nurse's most appropriate initial action?
Encourage the patient to take deep breaths and relax.
Prepare the patient for an abdominal ultrasound.
Administer oral proton pump inhibitors as prescribed.
Initiate intravenous (IV) access and administer fluids as prescribed.
The Correct Answer is D
A. Encouraging the patient to relax and breathe deeply does not address the immediate concerns of potential hemorrhage.
B. An abdominal ultrasound is not the first step in managing potential GI bleeding; stabilization is the priority.
C. Proton pump inhibitors are important for managing peptic ulcer disease, but the immediate priority is
stabilizing the patient’s condition.
D. Initiating IV access and administering fluids as prescribed is essential to stabilize the patient, manage shock, and address potential blood loss from gastrointestinal bleeding.
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Related Questions
Correct Answer is C
Explanation
A. Dextrose 10% in water is hypertonic and would exacerbate hypernatremia by further increasing sodium levels.
B. 25% albumin is not appropriate for treating hypernatremia and is typically used for volume expansion in cases of shock or hypoalbuminemia.
C. Dextrose 5% in water is an isotonic solution that helps dilute sodium levels and correct hypernatremia gradually.
D. Dextran 40 is a volume-expanding agent, not suitable for treating hypernatremia.
Correct Answer is B
Explanation
A. Encouraging the patient to take deep breaths and cough would not address the underlying cause of the symptoms, which may indicate a more serious condition.
B. Administering oxygen to maintain adequate oxygenation is the most appropriate initial action, as the patient’s symptoms suggest a potentially life-threatening condition like a cardiac tamponade or pulmonary embolism.
C. Positioning the patient flat in bed is not recommended, as it may exacerbate breathing difficulties and
the patient’s distress.
D. A warm compress is unlikely to be beneficial in this acute situation and could delay appropriate intervention.
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