NORCET 2 -2021 (Shift-2)
Medical & Surgical Nursing
Easy
Which types of stools are seen in Gastric bleeding?
Appeared in: NORCET 2 -2021 (Shift-2)
Explanation
- Gastric bleeding occurs in the upper gastrointestinal (GI) tract.
- When blood from the stomach passes through the intestines, it gets digested by enzymes and bacteria.
- This digestion process alters the blood, turning it into a black, sticky, and foul-smelling substance known as melena.
- Therefore, tarry-colored stool is the classic sign of an upper GI bleed.
Why Other Options Were Wrong
- Option B: Bright red blood in the stool (hematochezia) indicates that the blood is fresh and has not been digested. This is a hallmark of bleeding in the lower GI tract, such as the colon or rectum.
- Option C: The term 'coffee ground' describes the appearance of vomitus (hematemesis), not stool. It occurs when blood in the stomach is exposed to gastric acid, giving it a dark, granular appearance.
- Option D: A bilious (greenish-yellow) stool color is due to the presence of bile pigments. It is not associated with gastrointestinal bleeding.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Clinical manifestations of gastrointestinal bleeding helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- A nurse's accurate assessment and description of a patient's stool or vomitus are critical for helping physicians pinpoint the location and severity of a GI bleed.
- Noting a change from normal-colored stool to tarry stool is a key finding that must be reported immediately, as it indicates active or recent upper GI bleeding.
- What if? A patient with a known gastric ulcer suddenly passes a large amount of bright red blood from the rectum. This is a medical emergency. It signifies a massive upper GI bleed with such rapid transit that the blood did not have time to turn black. The nurse's priority is to assess for signs of shock (hypotension, tachycardia) and prepare for immediate fluid resuscitation and intervention.
How to Approach the Question
- First, identify the key terms in the question: 'Gastric bleeding' and 'stools'. 'Gastric' tells you the bleeding is in the stomach, which is part of the upper GI tract.
- Recall the pathophysiology of how blood changes as it moves through the GI tract. Blood from an upper source is digested, while blood from a lower source is not.
- Associate digested blood with a black, tarry appearance (melena). Associate fresh, undigested blood with a bright red appearance (hematochezia).
- Evaluate the options based on this understanding. 'Tarry color' matches the description for an upper GI bleed.
- Differentiate between terms for stool and vomitus. Recognize that 'coffee ground' applies to vomitus, not stool, making that option incorrect.
- Eliminate 'Bilious color' as it relates to bile, not blood.
Concept Tested & Keywords
- Concept Tested: Clinical manifestations of gastrointestinal bleeding
- Stem keywords: Gastric bleeding, stools
- Lead-in keywords: Which types
Question ID
QLsfuYyl0NYI_Qhx8HLpns
Reference Book
E6 Pathology-Vandana Puri & Kavita Gaur Textbook of Pathology and Genetics p. 459-461
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 137-139
E6 Medicine Harrison 22e Part 1 p. 357-359
Practise the full NORCET 2 -2021 (Shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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