Upon arrival on the medical surgical unit, VS: T 37.5° C (98.6° F), BP 106/54, P 114 and regular,

Upon arrival on the medical surgical unit, VS: T 37.5° C (98.6° F), BP 106/54, P 114 and regular, R22 and shalow. O2 saturation is 96% on RA. C.J. reports apain level of 6/10 in her epigastric area that is cramp- ing and intermittent, “coming in waves.” C.J. is A&0*4, PERRIA, apical pulse is rapid and steady at 114. Lung sounds are clear bilaterally; her abdomen is soft, extremely tender on light palpation with rebound tenderness and hyperactive bowel sounds in the LUQ, RUQ, and L L , and normal in the RLQ. Occasional borborygmi are present. MAE. Dorsalis pedis pulses are 2+ bilaterally without any dependent edema present. C.J. states, “I have been nauseated occasionally for the last few weeks on and off. Then this morning I started having severe cramping and vomiting that wouldn’t stop. I decided to come into the emergency room when I noticed the blood and the pain got too bad.” IV site: LFA 16 g without redness, tenderness, or swelling; transparent dressing in place, signed and dated. 1000 mL 0.9 NS running at 100 mL/hr on infusion pump. Identify aminimum of three underlying etiologies for upper GI bleed.

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