GI Bleeding Flashcards
Causes of upper GI bleeding
-Peptic ulcers (d/t H. pylori, NSAIDs)
-Stress ulcers (SRMD)
-Gastric angioectasia (idiopathic AVM common in older pop)
-Esophagitis (d/t GERD, smoking, alcohol use, irritating drugs)
-Esophageal varices d/t cirrhosis
-Esophageal Mallory-Weiss Tear
-cancer/tumors
-Crohn’s
Risk factors for gastric stress ulcers (SRMD)
Critical Illness:
-coagulopathy
-organ failure
-liver disease
-on dialysis
Mallory-Wiess esophageal tears are related to _________ _________
frequent vomiting
Explain the pathophysiology of esophageal varices
liver disease –> portal vein hypertension –> esophageal dilation –> thinning and rupture of esophageal walls
S/S of upper GI bleed
-hematemesis
-coffee ground emesis
-melena
Causes of lower GI bleeding
-IBD: Crohn’s and UC
-Diverticulosis –> diverticulitis
-ischemic colitis (d/t hypoperfusion)
-polyps
-angioectasias
-hemorrhoids
______________ are idiopathic small dilated blood vessels that can cause upper and lower GI bleeding, most commonly in older adults.
angioectasias
________ hemorrhoids are typically more painful than _________ hemorrhoids
External are more painful than internal
What trick can you use to distinguish gastric vs intestinal ulcers
Gastric: cause pain right after eating
Intestinal: cause pain 30 min - 2 hours after eating
S/S of lower GI bleeding
-bright red blood per rectum
-bloating
-hematochezia (blood in stool)
Causes of and one key S/S of esophagitis:
Risk factors:
-Corrosive meds
-Feeding tube
-Radiation therapy
-HIV, HSV
S/S: epigastric pain
MOA of PPIs (‘-prazoles’) for upper GI bleed
-reduces stomach acid
MOA of H2 blockers (famotidine, cimetadine)
-binds to H2 receptors, blocking histamine binding, reducing acid secretion
Side effects of steroids for Crohns, UC
-moon face, buffalo hump
-muscle wasting, osteoporosis
-acne, delayed wound healing, bruising
-anorexia, nausea
Pt education for preventing GI bleed:
-no NSAIDs
-no smoking, drinking
-manage stress
-avoid infection
Diverticulosis is often _________
painless
Nurse management for upper/lower GI bleed
-Assess–GI/GU, vitals (bleed risk!)
-IV fluids, blood PRN
-antibiotics if infection suspected
-glucocorticoids for IBD
-assist w/ endoscopic, coloscopic procedures
