A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following laboratory findings as indicating the client's gastrointestinal (GI) tract is digesting and absorbing blood?

The nurse must apply knowledge of protein metabolism and hepatic pathophysiology. When blood is digested in the gastrointestinal tract, it serves as a massive protein load. Understanding how the body processes these proteins helps identify specific markers of internal bleeding. Choice A rationale Hemoglobin A1c measures average blood glucose levels over the preceding three months. It is used to monitor long-term glycemic control in diabetic patients and does not change in response to acute gastrointestinal bleeding or protein digestion. Choice B rationale Blood contains high amounts of protein. When digested, bacteria break down these proteins into ammonia, which the liver normally converts to urea. Elevated BUN, typically 10 to 20 mg/dL, indicates the absorption of blood proteins. Choice C rationale Bilirubin levels, normally 0.3 to 1.0 mg/dL, usually increase in cirrhosis due to impaired hepatic processing. Digestion of blood would not cause a decrease in bilirubin; rather, hemolysis or liver failure would typically cause these levels to rise. Choice D rationale Chloride is an extracellular anion with a normal range of 98 to 107 mEq/L. Serum chloride levels are primarily affected by acid-base balance and renal function, not by the digestion and absorption of blood in the intestinal tract.