A nurse is caring for a newly admitted client with bleeding esophageal varices. Which of the following medications will the nurse anticipate a prescription for?

Choice A reason: Metoclopramide promotes gastric motility and is used for nausea or gastroparesis. It does not address bleeding esophageal varices, which require vasoconstriction to reduce portal hypertension. Its prokinetic effects may worsen bleeding by increasing gastric pressure, making this choice inappropriate for this condition. Choice B reason: Vancomycin is an antibiotic for bacterial infections, like MRSA or C. difficile. It has no role in managing bleeding esophageal varices, which stem from portal hypertension and require hemodynamic stabilization, not infection control, making this choice irrelevant for the client’s condition. Choice C reason: Octreotide, a somatostatin analog, reduces portal vein pressure by constricting splanchnic blood vessels, decreasing blood flow to varices. This controls bleeding in esophageal varices, a complication of liver disease, making it the preferred medication and the correct choice for this scenario. Choice D reason: Famotidine, an H2 receptor blocker, reduces gastric acid for ulcers or GERD. It does not address the vascular cause of bleeding varices, which requires portal pressure reduction. It may be adjunctive but is not primary, making this choice incorrect.