Which sign indicates possible internal bleeding in a patient receiving GP IIb/IIIa inhibitors?

• A. Hypertension and bradycardia
• B. Hypotension, tachycardia, changes in rhythm, blood in urine, back/abdominal pain, mental status changes, and black tarry stools
• C. Clear urine and normal vitals
• D. Rash and itching

Answer: (B)

These drugs block the final step of platelet aggregation, which raises the risk of bleeding. When internal bleeding occurs, you’ll see signs that reflect blood loss and reduced perfusion. Hypotension and tachycardia signal hypovolemia from ongoing bleeding. Changes in rhythm can occur with fluctuating perfusion and electrolyte disturbances. Blood in the urine points to genitourinary bleeding, while back or abdominal pain can indicate internal hemorrhage in those areas. Mental status changes suggest reduced brain perfusion from blood loss. Black tarry stools (melena) indicateGI bleeding. Together, these signs strongly point to internal bleeding in a patient on GP IIb/IIIa inhibitors.

Other choices don’t fit the pattern of internal hemorrhage: hypertension with bradycardia isn’t the typical presentation of acute bleeding; clear urine and normal vitals don’t suggest bleeding; rash and itching reflect hypersensitivity rather than bleeding.