Upper Gastrointestinal Bleeding Nursing Care And Management

Upper gastrointestinal bleeding can be a life-threatening condition, and proper nursing care plays a crucial role in stabilizing the patient and supporting recovery. Effective care involves a combination of immediate interventions, continuous monitoring, and coordination with medical professionals.

Immediate Patient Positioning And Airway Protection

Preventing aspiration is one of the top priorities, especially when a patient is experiencing hematemesis (vomiting blood). To reduce the risk of aspiration, nurses should position the patient with their head turned to one side. This is particularly important for elderly patients who are more vulnerable to complications from aspiration. Close monitoring of respiratory status and readiness to provide airway support is essential.

Rest And Activity Restriction

Patients must be advised to limit physical activity and remain in bed to reduce strain on the gastrointestinal system. Excessive movement, heavy lifting, or repeated changes in posture such as sitting up can exacerbate bleeding. Rest helps maintain stable blood pressure and reduces the risk of re-bleeding.

Gastric Tube Placement And Monitoring

In some cases, nasogastric tube insertion may be necessary. This allows healthcare providers to monitor the presence and amount of gastric bleeding. It can also be used for gastric lavage if needed. Proper placement and maintenance of the tube are essential to avoid complications and ensure accurate assessment.

Monitoring Bowel Movements And Stool Appearance

Nurses should closely monitor the patient's bowel movements for signs of melena — dark, tarry stools that indicate upper gastrointestinal bleeding. Tracking stool color and consistency helps in assessing the progression or resolution of the bleed. Any sudden changes should be reported to the medical team immediately.

Intravenous Fluids And Fasting

Fluid replacement therapy via intravenous (IV) lines is often required to maintain blood pressure and prevent shock. Patients are typically placed on nothing by mouth (NPO) status to allow the gastrointestinal tract to rest and prevent further irritation. Nutrition and hydration are managed intravenously until the bleeding is controlled and oral intake can be safely resumed.

Diagnostic And Therapeutic Follow-Up

If bleeding persists or recurs, a gastrointestinal endoscopy may be scheduled to identify the exact source of the bleed. Once a diagnosis is confirmed, appropriate treatment options such as endoscopic therapy, medication, or surgery can be considered. Nurses play a key role in preparing the patient for these procedures and monitoring for post-procedural complications.