Acute GI Hemorrhage

Question 1

what are clinical manifestations of an acute GI hemorrhage?

Answer 1

1. signs of hypovolemic shock due to hemorrhage
2. feeling of impending doom
3. melena and hematemesis with upper GI
4. hematochezia and black vomit with lower GI

Question 2

what are common sites for bleeding with upper GI?

Answer 2

esophageal varices and PUD

Question 3

what medications help treat upper GI problems?

Answer 3

PPIs, IV fluids, antibiotics for H.pylori, and sucralfate

Question 4

what are common sites for bleeding with lower GI problems?

Answer 4

1. polyps
2. diverticular disease
3. colorectal cancer
4. ulcerative colitis/ crohn’s

Question 5

what diagnostic testing can help check for upper GI problem and what prepocedure cautions should the patient take?

Answer 5

EGD is a diagnostic test for upper GI probems and patient must be NPO 24 hours before due to risk of aspiration

Question 6

what tests can diagnose lower GI problems?

Answer 6

colonscopy and endoscopy

Question 7

what labs are ordered for an acute GI hemorrhage?

Answer 7

1. CBC with H&H
2. Type and cross
3. H.pylori to determine PUD
4. stool for blood
5. BUN/Crt for perfusion status

Question 8

what are priority interventions to help treat an acute GI hemorrhage?

Answer 8

1. priority is to see patient with changes in LOC
2. NG tube decompression to get blood out of esophagus if this is an upper GI bleed
3. stop the bleeding
4. 2 large IVs and administer fluids or blood

Question 9

what are treatment options for a lower GI bleed?

Answer 9

1. treat the hypovolemic shock

2. IV fluids and blood as ordered

Question 10

what is the major complication with an acute GI hemorrhage and what are nursing care points here?

Answer 10

HYPOVOLEMIC SHOCK

1. note estimated blood loss
2. fluid resuscitation
3. give blood products
4. patient will go to ICU