A 31-year-old man is admitted to the hospital for suspicion of gastrointestinal bleeding. He has no significant past medical history but takes daily n

Subject
Medicine
System
Miscellaneous (Multisystem)

Kathryn

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Jul 29, 2020
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A 31-year-old man is admitted to the hospital for suspicion of gastrointestinal bleeding. He has no significant past medical history but takes daily nonsteroidal antiinflammatory agents for pain in his knee. He presented to the hospital 6 hours ago after he noticed melanotic stools while at home. He is observed to have copious bright red blood per rectum. On physical examination, he is tachycardic, and his peripheral pulses are faint but present. His mental status appears normal. His extremities are cool to the touch. An intravenous line is placed. Which of the following is the most appropriate next step in management?
(A) Order an urgent type and cross match for blood
(B) Order an urgent hematocrit level
(C) Begin parenteral administration of large volumes of normal saline solution
(D) Begin parenteral administration of large volumes of colloid solution
(E) Place two additional large bore peripheral intravenous catheters
 
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