The digestive or gastrointestinal (GI) tract consists of the esophagus, stomach, small intestine, large intestine or colon, rectum, and anus. GI bleeding can occur anywhere along the digestive tract. This type of bleeding is not a disease but a symptom of a disease. It may be caused by injury to the GI tract, ulcers, rupture of veins, drugs or cancers, among other things. GI bleeding may be seen in stool or in vomit and sometimes may not be noticed at all.
Things You'll Need
- Medical Surgical Nursing Text Book
- Nursing Diagnosis Text Book
Nursing Care for GI Bleeding
Assess the patient. Ask questions about changes in bowel pattern or color of his stool, alcohol consumption, medications like aspirin or anticoagulants, vomit in his blood and medical history. Perform a physical exam, paying attention to the abdomen. Check for stomach pain. Review medical records for laboratory tests that indicate bleeding.
Organize and analyze the information you obtained during your assessment, looking for problems that your patient may have due to GI bleeding. These problems should be signs, symptoms or effects of GI bleeding that are affecting your patient negatively. Formulate one or more nursing diagnoses based on the problem that you identified. In this case, your nursing diagnoses may be: 1) Fluid volume deficit related to blood loss and; 2) Imbalanced nutrition: Less than body requirements related to nausea, vomiting and diarrhea.
Write down the goals and objectives you want your client to meet based on the nursing diagnoses. In this case, your goal would be along the lines of: 1) Clients will maintain normal fluid volume as evidenced by urine output of at least 30 milliliters per hour and; 2) Clients will maintain balanced nutritional status as evidenced by stability in his weight.
List the nursing activities needed to meet these goals. For preventing complications of fluid volume deficit, monitor your patient's intake and output. Do this by measuring how much fluid he drinks and the amount of fluid he loses through urine. Monitor vital signs, especially blood pressure, for signs of hypovolemia or low blood volume. Observe him for signs of shock due to low blood volume like confusion, low urine output and low blood pressure.
To monitor nutritional status, your interventions could be weighing your client daily and administering intravenous fluids as ordered if he is restricted from eating or drinking.
Review your client's condition and goals to see they have been attained. Check if vital signs are stable and if his output has been within the normal range of 30 milliliters per hour, showing he has maintained his normal fluid volume. Look at his weight history to see if he has maintained a stable weight. If your objectives were not met, reassess your client and plan new interventions.
Initiate patient teaching. Teach your patient the signs and symptoms of GI bleeding. Instruct him to call his health care provider if he notices any signs of GI bleeding. Teach him about his medications, their expected side effects and how to take them. Educate your patient on how to avoid drugs that can cause bleeding like aspirin and to consult his doctor before taking any over-the-counter medication.
- "Lippincott Manual of Nursing Practice"; Sandra M. Nettina ANP-BC.; 2009
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