CHAPTER 7 Gastrointestinal System^305
- Diaphoresis (sweating)
- Nausea
INTERPRETING TEST RESULTS
- Positive fecal occult blood.
- Hemoglobin drops.
- Hematocrit drops.
- Anemia (iron deficiency) with chronic slow bleed.
- Nasogastric aspirate positive with upper GI bleed.
- Anoscopy, sigmoidoscopy, or colonoscopy may show site of lower GI bleed.
- Arteriography may show site of bleed.
- Bleeding scan may show site of bleed with radioisotope-tagged RBCs.
TREATMENT
- Maintain IV access.
- Administer isotonic fluids like normal saline.
- Monitor serial hemoglobin and hematocrit levels.
- Type and cross match for 3 to 6 units depending on amount of blood loss.
- Transfuse packed RBCs, type-specific when possible (type O negative when
type-specific unavailable—no time to get results back from lab yet). - May need to administer albumin or fresh frozen plasma, depending on amount
of units transfused and comorbidities such as cirrhosis or clotting disorders. - Endoscopic procedures to treat ulcer topically, with injectable or laser treatment.
- Esophageal varices may be treated by tamponade with Blakemore-Sengstaken
tube. - Surgery indicated when bleeding uncontrolled.
NURSING DIAGNOSES
- Deficient fluid volume
- Decreased cardiac output
- Anxiety