In a patient with a stress ulcer after severe trauma, which would be included in the initial assessment?

• A. Jaundice
• B. Gastrointestinal bleeding
• C. Hypertension
• D. Hypoglycemia

Answer: (B)

Stress-related mucosal damage after severe trauma can cause erosion of the gastric mucosa, leading to upper gastrointestinal bleeding. In the initial assessment, the priority is to detect signs of this bleed and its hemodynamic impact. Look for vomiting blood or black, tarry stools, and indicators of hypovolemia such as rapid heart rate or low blood pressure. Jaundice would point to liver injury rather than a stress ulcer issue presenting immediately after trauma. Hypertension is not typical in the setting of acute bleeding, and while hypoglycemia can occur in critically ill patients, it doesn’t define the immediate assessment focus for a stress ulcer. Therefore, gastrointestinal bleeding is the key finding to include early on.