ACTIVE LEARNING TEMPLATE: System Disorder
Kelly Gonzalez
STUDENT NAME _____________________________________
Gastrointestinal Bleed
DISORDER/DISEASE PROCESS __________________________________________________________ REVIEW MODULE CHAPTER ___________
Alterations in Pathophysiology Related Health Promotion and
Health (Diagnosis) to Client Problem Disease Prevention
*altered/impaired gastric outflow *impaired gastric elimination *quit smoking, decrease alcohol intake,
*risk of impaired oxygenation resulting in blood loss, due to the healthy diet/exercise, avoid
erosion/ulceration of the GI mucosa NSAIDS/corticosteroid as ordered,
*risk of dehydration manage stress
ASSESSMENT SAFETY
CONSIDERATIONS
Risk Factors Expected Findings *Monitor for
*chronic NSAID or corticosteroid use, infectous *abdominal discomfort/pain, dyspepsia orthostatic changes in
agents (H. pylori infection), family hx, pancreas constipation/diarrhea, nausea/vomiting, vital signs and
tumors/adhesions/fibrosis, excess alcohol hematisis, melena, low BP, high HR, tachycardia, (findings
consumption, andavced age, smoking, obesity, cramping, bloating, hyper/hypoactive bowels,
highly acidic foods, stress (anxiety/depression),
suggest
dizziness, confusion, wt loss, hernia GI bleeding or
(protrusion or lump), hematochezia perforation.
*monitor increased
risk of infection
Laboratory Tests Diagnostic Procedures *monitor adequate
oxygenation
*occult blood in stool sample *radiography, EGD, upper *Monitor for s/s of
*CBC/CMP: low H&H, low RBC and endoscopy, hydrogen breath test perforation (pain,
platelets bleeding, fever)
*ABGs indicate metabolic imbalance
*C13 urea breath test
PATIENT-CENTERED CARE Complications
*FVD/hypovolemia
Nursing Care Medications Client Education *metabolic
*Decrease environmental stimuli *Antacids (aluminum *avoid foods that cause alkalosis/acidosis
*Encourage rest breaks distress/restrict acid-producing foods
*monitor VS, I/O, CBC, CMP, pain or Mg+ hydroxide) *anemia (s/s: pallor,
*Keep client NPO until return of gag reflex *PPIs (Pantoprazole, *smoking cessation and avoiding
*insert NG tube for gastric decompression alcohol consumption glossitis, fatigue,
esomeprazole, *Notify the provider of coffee-ground and paresthesias)
omeprazole) emesis *obstruction (pyloric,
*stool softener *NPO 6-8 hr prior to EGD gastric outlet)
*Histamine2-receptor
antagonists *dumping syndrome
(Famotidine, (post gastrectomy sx)
Therapeutic Procedures cimetidine, and Interprofessional Care *perforation (s/s:
nizatidine) abdominal
*intermittent suctioning: NG *mucosal protectants *nutrition consult tenderness/rigidity)
tube w vent *antibiotic
*Prostaglandins *sugical intervention
*epinephrine or *supportive care
laser coagulation tx for areas
of bleeding (EGD determines
effectiveness)
ACTIVE LEARNING TEMPLATES