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학습 자료 둘러보기 →The combination of melena and a critically low hemoglobin of 7.2 g/dL confirms an active, major upper GI bleed. This level is below the common transfusion threshold of 7-8 g/dL and indicates severely compromised oxygen-carrying capacity.
Immediate nursing actions include assessing for signs of hypovolemic shock such as hypotension and tachycardia, ensuring large-bore IV access, and preparing for urgent blood transfusion. The provider must be notified immediately.
Do not confuse a supratherapeutic INR alone with an emergency. An INR of 2.8 is often therapeutic. The presence of active bleeding with hemodynamic instability, not just the lab value, dictates the urgency.
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