(^304) Medical-Surgical Nursing Demystified
- Avoid wearing clothing that is tight at waist.
- Avoid acidic foods (citrus, vinegar, tomato), peppermint, caffeine, alcohol.
- Stop smoking.
- Lose weight if overweight
Gastrointestinal Bleed
WHAT WENT WRONG?
Bleeding from the gastrointestinal tract may cause significant blood loss. The bleed-
ing may be from either the upper or lower gastrointestinal tract. Upper gastrointesti-
nal bleeds are commonly from ulcers, esophageal varices, neoplasms, arteriovenous
malformations, Mallory-Weiss tears secondary to vomiting, or anticoagulant use.
Lower gastrointestinal bleeds are commonly due to fissure formation, rectal trauma,
colitis, polyps, colon cancer, diverticulitis, vasculitis, or ulcerations.PROGNOSIS
The amount and speed of blood loss coupled with the patient’s age and co-
morbidities account for the prognosis. The greater the loss of blood, the harder it
is for the system to overcome the stress. Multiple transfusions to replace the lost
blood increase the patient’s risk for a reaction. Patients with blood-clotting disor-
ders have a greater risk of a significant bleed. Patients may go into shock if the
amount of blood loss is great, as they become hemodynamically unstable.HALLMARK SIGNS AND SYMPTOMS
- Hematemesis—vomiting of blood (red, maroon, coffee ground)
- Melena—black, tarry stool
- Hematochezia—red or maroon blood rectally
- Orthostatic changes—drop in BP of at least 10 mmHg with position changes
- Tachycardia as body attempts to circulate lesser blood volume
- Pallor due to decrease in circulating blood volume
- Lightheadedness
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