CHAPTER 7 Gastrointestinal System^307
- Epigastric area discomfort
 - Epigastric tenderness on palpation due to gastric irritation
 - Bleeding from irritation of the gastric mucosa
 - Hematemesis—possible coffee ground emesis due to partial digestion of blood
 - Melena—black, tarry stool
 
INTERPRETING TEST RESULTS
- Hemoglobin and hematocrit decrease.
 - Anemia (iron deficiency) due to chronic, slow blood loss.
 - Fecal occult blood positive.
 - Helicobacter pylorimay be positive.
 - Upper endoscopy shows inflammation, allows biopsy.
 
TREATMENT
- Administer antacids:
- Maalox, Mylanta, Tums, Gaviscon
 
 - Administer sucralfate to protect gastric lining.
 - Administer histamine 2 blockers:
- ranitidine, famotidine, nizatidine, cimetidine
 
 - Administer proton pump inhibitors:
- omeprazole, esomeprazole, pantoprazole, rabeprazole, lansoprazole
 
 - EradicateHelicobacter pyloriinfection if present.
 - Diet modification.
 - Monitor hemoglobin and hematocrit.
 
NURSING DIAGNOSES
- Risk for imbalanced nutrition: less than what body requires
 - Risk for imbalanced fluid volume
 - Nausea