Introduction
Gastrointestinal (GI) bleeding is a symptom of a digestive tract problem. Blood is frequently seen in feces or vomit, although it isn’t always visible, even if it causes the stool to appear dark or tarry. The severity of the bleeding can range from minor to severe, and it can be fatal. GI bleeding is a sign of an illness or condition, not a disease or disorder in itself.
Acute gastrointestinal bleeding occurs suddenly and can be pretty serious. Chronic gastrointestinal bleeding is a type of minor bleeding that can last for an extended period or come and go.
Upper GI bleeding occurs when bleeding occurs in the esophagus, stomach, or first part of the small intestine (duodenum). Lower GI bleeding refers to bleeding in the small intestine, large intestine, rectum, or anus.
The amount of blood you lose might range from a few drops to a life-threatening hemorrhage. Blood can only be detected by testing the stool in some cases since there is slight bleeding.
This blog post discusses GI bleed nursing diagnosis, care plans and interventions with elaborate examples .As you follow along, remember that our qualified writers are always ready to help in any of your nursing assignments. All you need to do is place an order with us!
Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.
Nursing Assessment for gi bleed
Causes of GI Bleeding
Upper GI bleeding can be caused by a variety of factors, including:
A peptic ulcer – is a type of stomach ulcer. The most prevalent cause of upper GI bleeding is this. Peptic ulcers are lesions that form on the stomach’s lining and the upper region of the small intestine. Stomach acid destroys the stomach lining, either due to germs or the use of anti-inflammatory medicines, resulting in sores.
Tears in the tube lining connecting the throat and stomach (esophagus). Mallory-Weiss tears are a type of tear that can result in a lot of bleeding. These are more common in those who consume excessive amounts of alcohol.
Veins in the esophagus that are abnormally swollen (esophageal varices). This disorder is particularly common in persons who have advanced liver illness.
Esophagitis – The most common cause of esophageal inflammation is gastroesophageal reflux disease (GERD). GI bleed Nursing Diagnosis
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Lower gastrointestinal bleeding ( – GI bleed Nursing Diagnosis and lower gi bleed nursing diagnosis)
The following are examples of possible causes:
Diverticular disease is a type of cancer that affects the intestine. This is characterized by the formation of tiny, bulging pouches in the digestive tract (diverticulosis). Diverticulitis occurs when one or more of the pouches become inflamed or infected.
Inflammatory bowel disease (IBD) is a type of bowel disease (IBD). Ulcerative colitis, which causes inflammation and ulcers in the colon and rectum, and Crohn’s disease, which causes inflammation of the digestive system lining, are examples.
Tumors. Tumors of the esophagus, stomach, colon, or rectum, whether benign or cancerous, can damage the digestive tract lining and cause bleeding.
Colon polyps. Bleeding can be caused by tiny clumps of cells that grow on the lining of your colon. Although the majority are safe, some are malignant or can become cancerous if not removed.
Hemorrhoids. Similar to varicose veins, these are bulging veins in the anus or lower rectum.
Anal fissures. These are tiny tears in the anus lining.
Proctitis. Rectal bleeding can be caused by inflammation of the rectum’s lining.
GI bleeding symptoms (care plans for gi bleed)
The indications of GI bleeding will vary depending on the location of the bleeding. The signs and symptoms of gastrointestinal bleeding differ from person to person. The following are some of the signs and symptoms:
Vomiting of blood. Blood can be crimson or brown in color, resembling coffee grounds.
Black stools with a foul odor.
Urine that is dark in color and contains clots. Urine can also have a nasty odor at times.
Abdominal pain, particularly in the left upper quadrant of the abdomen.
Severe stomach pains usually occur on one side of the abdomen or the other.
Tenderness in the abdomen.
Lightheadedness, often known as fainting, is a sense of being on the verge of passing out.
The person who is experiencing severe bleeding may also pass out.
There may be chest pains as well.
The person may not urinate at all, or if they do, it may infrequently be and in small amounts.
A quick heartbeat, clammy skin, pallor, and coolness of the extremities are all signs of gastric bleeding.
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GI Bleeding Nursing Diagnosis in care plans for gi bleed – nursing diagnosis for gastrointestinal
Stool test – examination of black, tarry stool; analysis of the sample for a fecal occult blood test to identify if there is any GI bleeding
Blood tests – complete blood count (CBC) may reveal a low hemoglobin count.
Nasogastric lavage is a procedure that involves inserting an NG tube through the nose into the stomach and aspirating and analyzing stomach contents.
The abdomen can be visualized with an abdominal CT scan.
Endoscopy, colonoscopy, and flexible sigmoidoscopy- all procedures that involve inserting a long tube with a tiny camera at the end into the GI tract to visualize it.
Capsule endoscopy is a procedure that involves swallowing a small capsule with a camera that takes photographs as it passes down the GI system.
Balloon-assisted enteroscopy is a procedure that allows a clinician to see areas of the small intestine that are not visible using endoscopy.
Hematinics or iron tests may reveal low iron levels; biochemistry may reveal impaired liver and kidney function.
Angiography is a procedure that involves injecting contrast material into an artery and using X-rays to examine and treat bleeding blood arteries.
Treatments for Gastrointestinal Bleeding -gi bleed treatment nursing
Hemorrhoids or anal fissures can be treated with a high-fiber diet, fluids to keep stools soft, and, if necessary, stool softeners. If they do not heal, surgery may be required to remove or repair them.
Serious gastrointestinal bleeding can cause a patient’s vital signs to become unstable. The patient’s blood pressure may drop suddenly while his heart rate rises. The doctor may need to administer IV fluids and potentially a blood transfusion to resuscitate the patient.
The patient may require surgery in some instances.
Nursing interventions for gastrointestinal bleeding
Patients with an upper GI bleed, such as stomach bleeding, may be administered IV proton pump inhibitors (PPIs) such as omeprazole (Prilosec) to decrease acid.
Suppose there is a lot of blood in the upper GI tract. In that case, prokinetics such as erythromycin or metoclopramide may be used to help clear the stomach of blood, clots, or food residue before an endoscopic operation.
If variceal (small blood vessel) bleeding is being treated, further drugs such as somatostatin or octreotide (Sandostatin) may be used, as well as antibiotics in patients with liver cirrhosis.
GI bleeding complications – care plans for gi bleed
When blood bleeds into the intestine, it causes a slew of problems. These are some of them:
Chronic anemia – is caused by blood loss due to intestinal fractures. Blood loss is usually gradual and occurs over a lengthy period, ranging from months to years. Anemia can result as a result of this.
When the gut wall or the blood vessels around it get engorged with blood and bulge, this is known as compartment syndrome. This puts pressure on nerves, causes muscular injury, or even necrosis, which leads to tissue death. Because this is a life-threatening situation, it is referred to as a surgical emergency.
Hematoma – A hematoma is a collection of blood in the tissues of the abdomen that causes swelling in the affected area. This puts pressure on organs, including the intestines and stomach, among other things. If the patients cannot be operated on to remove the tumors, they will eventually die.
Cecal volvulus – this occurs when the gut twists around itself due to GI bleeding. This obstructs the bowel, causing nausea and bloody vomiting, as well as hematochezia. Abscess creation — an abscess develops where GI bleeding occurs.
Nursing Care Plans for GI Bleeding Based on Diagnosis
Nursing Care Plan 1: Acute Pain
Pain-related to abdominal muscle spasms secondary to bleeding peptic ulcers. Diagnosis is supported/evidenced by a pain score of 10 out of 10, verbalization of chest pain or heartburn after eating, guarding signs on the chest or abdomen.
Desired Outcome (care plans for gi bleed)
The patient to demonstrate relief of pain as evidenced by a pain score of 0 out of 10, stable vital signs, and absence of restlessness.
| Interventions | Rationale |
| Administer prescribed medications that alleviate the symptoms of heartburn/stomach pain. | Antacids with no aspirin neutralize stomach acid.H2-receptor blockers to reduce the production of stomach acids.Proton–pump inhibitors to reduce the amount of stomach acid |
| Assess the patient’s vital signs and treatment for the relief of heartburn and pain characteristics at least 30 minutes after administration of medication. | To monitor the effectiveness of medical treatment to relieve heartburn and stomach pain. |
| Teach patient o how to perform non-pharmacological pain relief methods | To reduce the stress levels. Helps reduce the acute pain caused by GI bleeding. |
| Consider putting the patient in an NPO or nothing per orem/nothing by mouth status. | Allow the stomach lining to heal and prepare the patient for a diagnostic procedure. |
| Prepare patient for endoscopy. | Facilitates the diagnosis and treatment of bleeding peptic ulcers |
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Nursing Care Plan 2: Fluid Volume Deficit
Diagnosis-related to blood volume loss secondary to GI bleeding.
Diagnosis supported by hematemesis, skin pallor, the blood pressure level of
85/58, and lightheadedness.
Desired Outcome (care plans for gi bleed)
An absence of GI bleeding
A hemoglobin level of over 13.
Blood pressure level within normal range
A patient will be alert and orientated.
Normal skin color
| Interventions | Rationale |
| Assess vital signs, particularly blood pressure level. | Hypovolemia due to GI bleeding may lower blood pressure levels and put the patient at risk for hypotensive episodes that lead to shock that lead to shock. |
| Commence a fluid balance chart, monitoring the input and output of the patient. | To monitor the patient’s fluid volume accurately. |
| Start intravenous therapy as prescribed. Electrolytes may need to be replaced intravenously. Encourage oral fluid intake of at least 2000 mL per day if not contraindicated. | To replenish the fluids and electrolytes lost from vomiting or other gastric losses and promote better blood circulation around the body. |
| Educate the patient on how to fill out a fluid balance. | Help patients take care of their own care. |
| Administer blood transfusions prescribed. | To increase the hemoglobin level and treat anemia and hypovolemia related to GI bleeding. |
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References
- ncbi.gov
- scholar.google.com
- care plans for gi bleed
