ESTUDYR
NCLEX-RN Case Study: Upper GI Bleed
(Esophageal Varices)
Client Scenario
1800 Nurses' Notes: A 58-year-old male with a history of cirrhosis and portal hypertension is
admitted to the Progressive Care Unit (PCU). He suddenly begins vomiting large amounts of
bright red blood. He is pale, diaphoretic, and appears extremely agitated.
Physical Assessment:
Gastrointestinal: Hematemesis (approximately 500 mL of bright red blood).
Abdomen is distended with caput medusae.
Vital Signs: BP 88/54, HR 128, RR 26, SpO2 92% on Room Air.
Neuro: Alert but confused and restless.
Item 1: Recognizing Cues
Question: Click to highlight the findings that indicate the client is in Hypovolemic Shock.
Findings: 58-year-old male; vomiting large amounts of bright red blood; pale and
diaphoretic; BP 88/54; HR 128; RR 26; confused and restless.
Rationale: Profuse hematemesis leads to rapid volume loss. Tachycardia (HR 128) and
hypotension (BP 88/54) are the classic signs of shock. Diaphoresis and pale skin result from
the body shunting blood to vital organs.
Item 2: Analyzing Cues
Question: The nurse anticipates which laboratory findings for this client? (Select All That
Apply)
1. ✅Hemoglobin: 7.2 g/dL (Normal: 14–18 g/dL)
2. ✅Blood Urea Nitrogen (BUN): 45 mg/dL (Normal: 10–20 mg/dL)
3. ✅Serum Creatinine: 0.8 mg/dL
4. ✅Prothrombin Time (PT): 24 seconds (Normal: 11–13.5 seconds)
NCLEX-RN Case Study: Upper GI Bleed
(Esophageal Varices)
Client Scenario
1800 Nurses' Notes: A 58-year-old male with a history of cirrhosis and portal hypertension is
admitted to the Progressive Care Unit (PCU). He suddenly begins vomiting large amounts of
bright red blood. He is pale, diaphoretic, and appears extremely agitated.
Physical Assessment:
Gastrointestinal: Hematemesis (approximately 500 mL of bright red blood).
Abdomen is distended with caput medusae.
Vital Signs: BP 88/54, HR 128, RR 26, SpO2 92% on Room Air.
Neuro: Alert but confused and restless.
Item 1: Recognizing Cues
Question: Click to highlight the findings that indicate the client is in Hypovolemic Shock.
Findings: 58-year-old male; vomiting large amounts of bright red blood; pale and
diaphoretic; BP 88/54; HR 128; RR 26; confused and restless.
Rationale: Profuse hematemesis leads to rapid volume loss. Tachycardia (HR 128) and
hypotension (BP 88/54) are the classic signs of shock. Diaphoresis and pale skin result from
the body shunting blood to vital organs.
Item 2: Analyzing Cues
Question: The nurse anticipates which laboratory findings for this client? (Select All That
Apply)
1. ✅Hemoglobin: 7.2 g/dL (Normal: 14–18 g/dL)
2. ✅Blood Urea Nitrogen (BUN): 45 mg/dL (Normal: 10–20 mg/dL)
3. ✅Serum Creatinine: 0.8 mg/dL
4. ✅Prothrombin Time (PT): 24 seconds (Normal: 11–13.5 seconds)
