Nursing Care Plans

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1. Pathophysiology
2. Nursing Assessment
3. Nursing Interventions

GI Bleed Pathophysiology

Gastrointestinal (GI) bleeding occurs when there is bleeding in any part of the digestive system, including the esophagus, stomach, small or large intestine. GI bleeding can be acute or chronic, and it is usually caused by peptic ulcer disease, gastritis, esophagitis, diverticulitis, or inflammatory bowel disease. The severity of GI bleeding depends on the amount and rate of bleeding, as well as the underlying cause.

GI Bleed Causes

• Peptic ulcer disease
• Gastritis
• Esophagitis
• Diverticulitis
• Inflammatory bowel disease
• Hemorrhoids
• Gastrointestinal tumors
• Portal hypertension

GI Bleed Symptoms

• Bright red blood in vomit or stools
• Dark, tarry stools
• Abdominal pain
• Nausea
• Vomiting
• Weakness
• Fatigue
• Shortness of breath
• Dizziness

Subjective Data (Client may report)

• Abdominal pain
• Nausea
• Vomiting
• Loss of appetite
• Dizziness
• Weakness

Objective Data

• Palpable abdominal mass
• Hematemesis (vomiting of blood)
• Melena (black, tarry stools)
• Hypotension
• Tachycardia
• Pallor
• Cool, clammy skin

GI Bleed Risk Factors

• Advanced age
• Chronic alcohol use
• Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs)
• Smoking
• Family history of gastrointestinal disease
• Liver disease

Gastrointestinal Bleeding Nursing Assessment

Cardiac Function

• Increased blood pressure and heart rate
• Irregular cardiac rhythm

Respiratory Function

• Irregular respiratory rate, oxygen saturation, and/or lung sounds
• Possible hypoxia or respiratory failure

Neurologic Function

• Low level of consciousness
• Changes in neurological status (decrease in cerebral perfusion)

Sensory Function

• Changes in vision and hearing

GI Bleed Labs

• Hemoglobin and hematocrit
• Platelet count
• Prothrombin time (PT) and international normalized ratio (INR)
• Fibrinogen
• Liver function tests

Nursing Interventions for GI Bleed

• Monitor vital signs and oxygen saturation.
• Administer oxygen, blood transfusions, and medications as prescribed.
• Insert an IV catheter for fluid resuscitation.
• Prepare the client for endoscopy or surgery, if necessary.
• Educate the client on dietary modifications and medication management post-discharge.

GI Bleed Goals and Outcomes

• Maintain stable vital signs and oxygen saturation.
• Achieve and maintain a hemoglobin level of greater than 8 g/dL.
• Reduce or stop the bleeding.