Nurse Moose
    Ati med surg iii proctored exam mdc 2

    A 58-year-old man with known alcoholic cirrhosis presents to the emergency department with massive hematemesis and progressive abdominal distension. On examination, he is hypotensive (BP 85/60 mmHg), tachycardic (HR 110 bpm), and has tense ascites. Endoscopy reveals actively bleeding esophageal varices. Which of the following is the most appropriate initial management step?