GI Bleed (Upper, Lower) for Progressive Care Certified Nurse (PCCN)

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Outline

GI Bleed (Upper, Lower)

 

Definition/Etiology:

  • Injury to GI tract lining
    • Causes
      • Injury/trauma
      • Medications
      • chronic conditions (UC, Crohn’s, CA)

 

Pathophysiology:

  • Bleeding may not stop
    • Will show two locations of injury
    • Explain why injuries can reoccur
    • Why the color of emesis/stool is what we see

 

Noticing: Assessment & Recognizing Cues:

  • Bloody emesis (may be “coffee ground”, don’t forget to measure if possible)
  • Rectal bleeding
  • Abdominal pain
  • Faint/lightheadedness

 

Interpreting: Analyzing & Planning:

  • Complete Blood Count (CBC)
  • Endoscopy
  • Colonoscopy

 

Responding: Patient Interventions & Taking Action:

  • Proton Pump Inhibitor- upper
  • Blood Transfusion (make sure T&C and signed consent for blood in chart)
  • Severe Bleeding
    • Cauterize

 

Reflecting: Evaluating Patient Outcomes:

  • Bleeding improved
  • Pain decreased

 

Linchpins (Key Points):

  • Location matters!
    • Dark red stool is HIGH
    • Bright red stool is LOW
    • Bloody/coffee-ground emesis is HIGH

 

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