Gastrointestinal Bleeding Nursing Diagnosis And Patient Care Strategies

When managing upper gastrointestinal bleeding, a comprehensive nursing diagnosis is essential to ensure patient safety and effective treatment outcomes. This involves a systematic approach to monitoring, intervention, and patient stabilization.

Immediate Care For Active Bleeding Patients

The first priority in nursing diagnosis is to stabilize patients currently experiencing bleeding. Vital signs such as respiration, pulse, and blood pressure must be closely monitored and documented regularly. This allows for early detection of deterioration and timely medical intervention.

Patients should be positioned on their side to prevent aspiration, especially if they are unconscious or at risk of vomiting. Oral intake of food and medication must be restricted until the bleeding is controlled to avoid further gastrointestinal irritation.

Accurate documentation of fluid intake and output is crucial in assessing the patient's hemodynamic status and kidney function. This includes tracking urine output, vomitus, and any ongoing blood loss.

Administration And Monitoring Of Intravenous Therapy

Nursing staff must carefully verify all intravenous fluids and blood products before administration to prevent errors. This includes confirming compatibility, dosage, and infusion rate based on physician orders.

Regular rounds to check on patients are necessary to monitor for signs of infiltration, extravasation, or changes in infusion speed. Adjustments to the IV rate should be made promptly to maintain therapeutic effectiveness and prevent complications.

Management Of Variceal Bleeding In Cirrhosis Patients

Use Of Sengstaken-Blakemore Tube

For patients with bleeding esophageal varices due to liver cirrhosis, the use of a Sengstaken-Blakemore tube may be necessary to apply pressure and achieve hemostasis. Nurses must ensure proper placement and function of the tube.

Continuous assessment of the balloon pressure and effectiveness of the compression is vital. Nurses should regularly check for signs of re-bleeding and ensure that the pressure remains within the recommended range to avoid tissue necrosis or complications.