T. Upper Gastrointestinal Bleeding

Question 1

Upper Gastrointestinal Bleeding

Answer 1

• caused by trauma, medication use, and/or alcohol and tobacco use.
• Bleeding typically originates in the esophagus, stomach, or duodenum,

Question 2

Hematemesis

Answer 2

• blood vomitus

* fresh bright red or “coffee grounds” if in contact with HCL

Question 3

Melena

Answer 3

black tarry stools, foul smelling

Question 4

Occult bleeding

Answer 4

small amount of blood in gastric secretions. Not apparent by sight

gastrointestinal bleeding that is not visible to the patient or physician

Question 5

A massive upper GI hemorrhage

Answer 5

• a loss of more than 1500 mL of blood or 25% of the intravascular blood volume
• May lead to shock, as identified by tachycardia, weak pulse, hypotension, cool extremities, prolonged capillary refill, and apprehension

Question 6

endoscopic hemostasis

Answer 6

safe and effective method to control high-risk indications of hemorrhage: active bleeding, nonbleeding visible vessel, or adherent clot.

Question 7

Patient education

Answer 7

Emphasize that no drugs (especially NSAIDs, including aspirin) other than those prescribed by the healthcare provider should be taken. Smoking and alcohol should be stopped

Question 8

The severity of bleeding depends on whether the origin is venous, capillary, or arterial.

Answer 8

• arterial source is profuse and the blood is bright red, indicating it has not been in contact with gastric hydrochloric acid (HCl)
• coffee-ground vomitus indicates that the blood has been in the stomach for some time.