Summary Medical surgical nursing GI bleed study guide.

GI Bleed
Med Surg: GI - Gastrointestinal

Pathophysiology

Bleeding anywhere inside the GI tract. Upper GI

Classified as upper or lower GI bleed - one of the biggest
problems is knowing the exact location of the bleed! Lower GI




Upper GI Upper GI bleed NCLEX TIP
NCLEX TIPS NCLEX TIP
Gastritis, GERD, Peptic ulcer NCLEX TIP GERD
Colorectal cancer Vomiting: Hematemsis
Esophageal varices
“coffee ground emesis”
Lower GI Gastritis Peptic Ulcer Stool: Melena
“dark or black tarry stools”
Hemorrhoids
Colorectal cancer NCLEX TIP
Lower GI bleed
Diverticulosis
Ulcerative colitis Bright red bleeding




Guaiac Fecal Occult Blood Te Hypovolemic Shock! (hemorrhagic shock)
Positive NORMAL




HIGH
L OW
NCLEX TIP Hypotension (Low BP) HR > 100
Gather supplies, wash hands,
Step 1 Tachycardia (High HR)
non-sterile gloves
Pale skin Below 7
Open & apply stool samples to the Cool, Clammy “diaphoretic”
Step 2 HEMOGLOBIN
boxes on the slides
Fatigue & dizzy
Open the back of the slide
Step 3
& apply 2 drops of developing solution Low CBC Labs:
Low H/H NCLEX TIPS
Step 4 Wait 30-60 seconds Hemoglobin Less than 7 = Heaven
Step 5 Document the results



In Surgery

Includes procedures to locate & stop the bleeding.
Priority Actions ope out the bowels.
1. Lower head of bed NCLEX TIP
2. IV Normal Saline = Stabilizes Blood Pressure
3. Oxygen Endoscopy - Upper GI
4. Blood Transfusion Colonoscopy - Low GI
Hemoglobin Less than 7 NCLEX TIP


Upper GI bleed:
Nasogastric lavage (NGT) NCLEX TIP
AFTER “-Scopy”
NO NGT for gastroesophageal varices
Clear liquids:
Apple juice
Broth soup
Tea (unsweet)