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

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