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Discussion

Care Plan/Map for Lower GI Bleeding

Hi All

I'm hoping you can help. My father was admitted yesterday with lower GI bleeding of unknown origin.

Does anyone have any nursing care plans/care maps for this diagnosis?

I work in cardiac surgery, so I'm a little out of my realm, but, I was appalled that the nurse did not check a postural blood pressure after he asked for assitance from the bathroom to the bed because of dizziness/lightheadedness. :uhoh21:

The nurse had no hestiation about medicating him with both metoprolol and lisinopril (at the same time) about 20 minutes later, still without checking any b/p! :uhoh3:

What's the standard of care for an active gi bleeder?

thanks!

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hey there..just for your info...

Usually pt's with lower BGITs are monitored on hrly vital signs...and having their Full blood count taken usually once a day every monring subject to results obtained.

Fluid challenge or blood transfusion are usually needed if too much bleeding occurs, HB blood serum is low, significant hypovolaemic state.

pt 's are usually put on NBM(nil by mouth) and iv drip.

Usually we insert an NGT and catheterise the pt.

IN addition, a colonoscopy would usually be done either the next day if pt's condotion is stable or done as urgent. Usually to locate area of bleed..and source of bleed...

pt would usually be placed on iv losec(omeperazole) conitnuous to protect the gi mucousal lining in view of a possible bleed due to ulcers.

iadditionally a mesentric angiogram might be done if no source of bleeding is found in the lower GI.

IN regards to your dad's dizziness...its probably due to having a LOw HB, possible postural hypotension....but anyway...the nurse ought to have checked his bp for baseline. Serving the meds is not the point...as it only hleps to ease his symptoms...

frankly..he should be RIB(rest in bed) and given bedside toilet priviledges.

Anyway....hope your dad is better by the day. Take care

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