A 48-year-old man arrives in the emergency department. He felt well until 2 hoursago, when he became nauseated and subsequently vomited a large amount of redblood and clots. He reports a long history of alcohol use and cigarette smoking. Hetakes no medications. Laboratory data were hemoglobin, 9.6 g/dl; hematocrit,28.4%; platelet count, 92,000/mm3; PT, 16.5 seconds (normal, 11 to 15); alkalinephosphatase, 120 units/L (normal, 20 to 90); AST, 265 units/L; ALT, 112 units/L.Factors to Consider.1.What is likely to be a major underlying cause of this client’s problem?2.Is it reversible?3.Can further damage be stopped?4.With the client vomiting blood, what should be your priority interventions?5.What gastrointestinal disorders can be manifested in people who consume large quantities of alcohol?6.What risks does the client face in the present situation?
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