Question

A nurse is caring for a newly admitted patient who has gastric hemorrhage and is going into shock. Identify the sequence of actions the nurse should take:

Option 1: Initiate IV therapy with a large bore catheter.
Option 2: Give oxygen via a non-rebreather mask.
Option 3: Insert an NG tube.
Option 4: Give ranitidine.

Select the correct option from the following:

a) Option 1, Option 2, Option 3, Option 4
b) Option 2, Option 1, Option 3, Option 4
c) Option 1, Option 2, Option 4, Option 3
d) Option 2, Option 1, Option 4, Option 3

Answer 1

The nurse should first give oxygen to the patient, then initiate IV therapy, followed by administering ranitidine and finally insert an NG tube; making the sequence b) Option 2, Option 1, Option 4, Option 3 the correct set of actions to manage a patient with gastric hemorrhage going into shock.

Step-by-step explanation:

When a nurse is caring for a newly admitted patient who has gastric hemorrhage and is going into shock, the sequence of actions to take is vital. The priority is to ensure that the patient's oxygenation and circulatory status are addressed first. Therefore, the correct sequence of actions should be:

1. Option 2: Give oxygen via a non-rebreather mask.
2. Option 1: Initiate IV therapy with a large bore catheter.
3. Option 4: Give ranitidine.
4. Option 3: Insert an NG tube.

Providing oxygen is an immediate concern due to the risk of hypoxia, so option 2 is the first step. Once oxygen is being provided, initiating IV therapy with a large bore catheter allows for rapid fluid resuscitation, addressing the hypovolemic aspect of the shock, making option 1 the second step. After addressing the more critical life-threatening concerns, administering ranitidine helps reduce acid secretion and stabilize the gastric environment, and inserting an NG tube can help decompress the stomach and remove blood, making options 4 and 3 the subsequent steps respectively. Hence, the correct answer is sequence b) Option 2, Option 1, Option 4, Option 3.