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Understanding acute upper gastrointestinal bleeding in adults

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


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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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