The patient is admitted with generalized fatigue and a low hemoglobin and hematocrit (anemia). The patient denies vomiting and states that his last bowel movement earlier that day was normal in color and consistency
However, because GI blood loss can be a cause of anemia, the nurse should expect to: a. obtain a stool sample for guaiac testing.
b. chart that the patient reports the presence of melena in his stool.
c. inspect the patient's next stool for the presence of coffee-ground contents.
d. obtain guaiac positive stools only if bleeding is current.
A
GI blood loss is often occult or detected only by testing the stool with a chemical reagent (guaiac). Stool and nasogastric drainage can test guaiac positive for up to 10 days after a bleeding episode. Melena is shiny, black, foul-smelling stool and results from the degradation of blood by stomach acids or intestinal bacteria. Vomiting or drainage from a nasogastric tube that yields blood or coffee-ground–like material is associated with upper GI bleeding. However, blood or coffee-ground–like contents may not be present if bleeding has ceased or if it arises beyond a closed pylorus.
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