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Understanding acute upper gastrointestinal bleeding in adults

Author Information
doi: 10.1097/01.NURSE.0000662856.64285.d9
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INSTRUCTIONS Understanding acute upper gastrointestinal bleeding in adults

TEST INSTRUCTIONS

  • Read the article. The test for this CE activity is to be taken online at www.nursingcenter.com/CE/nursing.
  • You'll need to create (it's free!) and log in to your personal CE Planner account before taking online tests. Your planner will keep track of all your Lippincott Professional Development online CE activities for you.
  • There's only one correct answer for each question. A passing score for this test is 13 correct answers. If you pass, you can print your certificate of earned contact hours and access the answer key. If you fail, you have the option of taking the test again at no additional cost.
  • For questions, contact Lippincott Professional Development: 1-800-787-8985.
  • Registration deadline is March 4, 2022.

PROVIDER ACCREDITATION

Lippincott Professional Development will award 1.0 contact hour for this continuing nursing education activity. Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.0 contact hour, and the District of Columbia, Georgia, and Florida CE Broker #50-1223.

Payment: The registration fee for this test is $12.95.

Understanding acute upper gastrointestinal bleeding in adults

GENERAL PURPOSE: To provide an overview of adult patients with acute UGIB. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Explain the pathophysiology of acute UGIB. 2. List risk factors for acute UGIB. 3. Identify nursing considerations for patients with UGIB.

  1. In the US, mortality from UGIB is
    1. 20.5% to 30%.
    2. 10.5% to 20%.
    3. 3.5% to 10%.
  2. Patients may be at an increased risk for UGIB if they are
    1. females.
    2. Non-Hispanic Whites.
    3. over age 60.
  3. UGIB refers to bleeding from the esophagus, stomach, or
    1. duodenum.
    2. jejunum.
    3. ileum.
  4. What is the most common cause of UGIB?
    1. Mallory-Weiss tears
    2. PUD
    3. esophagogastric varices
  5. Gastric injury from what drugs account for approximately 20% of UGIB?
    1. NSAIDs
    2. beta-blockers
    3. antibiotics
  6. Esophagogastric varices are associated with dilated esophageal and gastric veins predominately caused by
    1. anticoagulant use.
    2. portal hypertension.
    3. forceful vomiting.
  7. Longitudinal mucosal lacerations in the distal esophagus and proximal stomach from profuse and forceful vomiting or gagging are called
    1. Ménétrier disease.
    2. Zollinger-Ellison syndrome.
    3. Mallory-Weiss tears.
  8. Which dietary intake data would be most significant in patients presenting with signs of UGIB?
    1. alcohol use
    2. spicy foods
    3. coffee intake
  9. What is considered the most sensitive indicator of volume status?
    1. oliguria
    2. tachypnea
    3. tachycardia
  10. Typically, UGIB presents with stool that is
    1. maroon.
    2. tarry black.
    3. bright red.
  11. Within the first 24 hours of UGIB, a patient's hemoglobin levels will likely present
    1. under baseline.
    2. at baseline.
    3. above baseline.
  12. The preferred diagnostic study for acute UGIB is a(n)
    1. barium swallow.
    2. angiography.
    3. upper endoscopy.
  13. Initial clinical management of patients with UGIB includes
    1. a clear liquid diet.
    2. supplemental oxygen.
    3. a small-gauge peripheral I.V. catheter.
  14. One of the initial treatment goals for a patient with UGIB is
    1. nutritional support.
    2. pain control.
    3. airway maintenance.
  15. Patients with ongoing hematemesis or altered respiratory or mental status should be considered for
    1. endotracheal intubation.
    2. vitamin K administration.
    3. prothrombin complex concentrate infusion.
  16. What drug class is associated with healing erosions, decreasing drug-induced gastritis, and reducing rates of UGIB?
    1. histamine-receptor agonists
    2. antacids
    3. PPIs
  17. Octreotide helps reduce variceal pressure by
    1. inhibiting the release of gastrin.
    2. increasing visceral blood flow.
    3. promoting splanchnic vasodilation.
  18. The urinary output goal for a patient with UGIB is at least
    1. 10 mL/kg/h.
    2. 2.0 mL/kg/h.
    3. 0.5 mL/kg/h.
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