A patient with suspected gastrointestinal (GI) bleeding is tachycardic and pale. What is the priority nursing action?

• A. Establish IV access and initiate fluid resuscitation
• B. Monitor vitals and call for help
• C. Administer antacids
• D. Check stool guaiac

Answer: (A)

When a patient shows signs of GI bleeding with tachycardia and pallor, the priority is to restore circulating blood volume and perfusion. The first action is to establish IV access and begin fluid resuscitation with an isotonic crystalloid solution. This addresses the immediate risk of hypovolemia from ongoing blood loss, supports organ perfusion, and stabilizes the patient enough to proceed with diagnostic tests and definitive treatment. Starting fluids also allows time to prepare for potential blood products and to obtain baseline labs (hemoglobin, hematocrit, electrolytes, coagulation studies) needed for ongoing management.

Delaying resuscitation to monitor vitals alone or to perform non-emergency tasks risks progression to shock and organ dysfunction. Administering antacids does not address the volume loss or the bleeding. Checking stool guaiac is important for diagnosis but should occur after or alongside stabilization, not before addressing hemodynamic status.