Hematemesis

Definition

Hematemesis is the vomiting of blood. Bright red blood suggests active, brisk bleeding; coffee-ground emesis indicates digested blood from slower or older bleeding.

Common Causes

• Peptic ulcer disease (most common)
• Esophageal varices (cirrhosis)
• Mallory-Weiss tear (forceful vomiting)
• Gastritis or esophagitis
• Gastric cancer

Nursing Interventions

Assess airway and hemodynamic status, such as establish 2 large-bore IVs, type and crossmatch, CBC, coagulation labs. Administer crystalloids/blood products as ordered. Monitor vital signs closely. NPO. Prepare for emergent EGD. For variceal bleeding: octreotide, vasopressin, band ligation, or Blakemore tube. Position in left lateral if actively bleeding.

NCLEX Relevance

Coffee-ground emesis = upper GI bleed cue. Priority: airway and volume resuscitation.