When planning care for a patient with melena, the nurse expects which appearance of the stool?
A) Coffee ground appearance of the stool
B) Black and tarry stools
C) Bright red blood in the stool
D) Visually undetectable blood
B) Black and tarry stools
Explanation: A) Hematemesis (vomitus) may contain frank, bright red (undigested) blood or dark, grainy (digested) blood, described as having a coffee ground appearance.
B) Upper GI bleeding may present as blood in the patient's stool, known as melena. Melena is black, tarry stools caused by digestion of blood in the GIT.
C) Lower GI bleeding is bleeding from the small intestine, large intestine, colon, or rectum and may present as melena or frank, bright red blood in the stool (hematochezia).
D) Both upper and lower GI bleeding may present as occult bleeding. Occult blood is due to slow, chronic bleeding and is not detectable by routine inspection of the stool or gastric secretions. Occult blood is detected only through a guaiac test.
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