GI Bleed & Hypovolemic Shock MSIII
UPDATED ACTUAL Questions and
CORRECT Answers
Gastrointestinal bleeding may involve.. - CORRECT ANSWER- ✔✔rapid onset or insidious
occult bleeding
>1L in 24 hours blood loss - CORRECT ANSWER- ✔✔signs of hypovolemic shock can
occur such as hypotension, chills, palpitations, diaphoresis, and a weak pulse
loss of 1500ml or 25% volume - CORRECT ANSWER- ✔✔MASSIVE BLEED
When the pt is bleeding out, what are the priorities? - CORRECT ANSWER- ✔✔ABGS
(oxygen and fluid bolus)
monitor vitals frequently
pt gets 2 IVs!: 16-18 minimum 20 gauge for blood
Massive GI Bleed pathophysiology - CORRECT ANSWER- ✔✔can deplete blood volume,
cause decreased cardiac output, tachycardia, hypotension, pallor, decreased urinary output,
constriction of peripheral blood vessels to maintain perfusion to vital organs
what is one of the firsy signs of hypovolemic shock? - CORRECT ANSWER-
✔✔tachycardia
*hypotension isnt always appearing right away*
complication of massive GI bleed: - CORRECT ANSWER- ✔✔hypovolemic shock
what is hematemesis? - CORRECT ANSWER- ✔✔bright red blood that has not been in
contact with stomach acid
, what is coffee ground emesis? - CORRECT ANSWER- ✔✔dark brown color with grainy
appearance that has been in contact with stomach acid
what is melena? - CORRECT ANSWER- ✔✔black tarry stools indicate slow bleed from an
upper GI source. Stools often have a
FOUL odor. Color is related to iron.
what is hematochezia? - CORRECT ANSWER- ✔✔contains frank blood
What can blood in the GI track stimulate? - CORRECT ANSWER- ✔✔peristalsis!
hyperactive bowel sounds
what is occult bleeding? - CORRECT ANSWER- ✔✔small amount of blood in stool, emesis,
or gastric secretions, not apparent to the naked eye. Detected by guaiac.
what are the two orgins of GI bleed? - CORRECT ANSWER- ✔✔PUD and Esophageal?
What is PUD?
(most common) - CORRECT ANSWER- ✔✔Ulcers in the stomach or duodenum frequently
penetrate a blood vessel and cause bleeding. Chronic ulcers often cause deeper erosion than
ACUTE ULCERS
What is Chronic Esophagitis? - CORRECT ANSWER- ✔✔related to H. Pylori infection
ETOH,cigarettes,medication,or GERD causing ACID reflux/erosion
What is Mallory-Weiss tear? - CORRECT ANSWER- ✔✔severe vomiting can cause a tear at
junction of esophagus and stomach causing severe bleeding
What is esophageal varices? - CORRECT ANSWER- ✔✔often secondary to cirrhosis,
vessels become engorged and increase in pressure from sneezing, coughing, vomiting can
cause rupture and sudden massive bleeding. (Highest mortality)
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