Two weeks after a severe burn over 20% of the body, the client vomits bright red blood. Which condition is likely?

A. Curling's ulcer: Curling's ulcers are acute stress-induced gastric ulcers that commonly occur in clients with severe burns covering more than 20% of the body. The physiological stress from the burn, along with hypovolemia and reduced gastric mucosal perfusion, leads to ischemia of the gastric lining. This increases the risk of ulcer formation and gastrointestinal bleeding, which may present as hematemesis (vomiting bright red blood) approximately 1–2 weeks post-injury. B. Paralytic ileus: Paralytic ileus involves temporary cessation of intestinal peristalsis, leading to abdominal distension, nausea, and vomiting. While it can occur after burns or surgery, it does not typically cause bright red blood in vomitus, as it primarily affects bowel motility rather than causing gastric mucosal bleeding. C. Hypoglycemia: Hypoglycemia may cause symptoms such as shakiness, diaphoresis, confusion, and sometimes vomiting, but it is not associated with gastrointestinal bleeding. Bright red blood in vomitus is not a feature of low blood glucose levels. D. Gastric reflux: Gastroesophageal reflux can cause regurgitation of stomach contents, sometimes with small amounts of blood from minor esophageal irritation, but it rarely produces significant bright red hematemesis. The severity and timing of this client’s presentation are more consistent with a stress-induced ulcer rather than simple reflux.