Hey guys! So for med surg teat outs, we have to perform a scenario on the sim man. It's going to be an upper gi bleed, however, we have NO CLUE what to do for this, it's no where in the book and quite frankly the school isnt helping us be successful, they're throwing us in the room and saying good luck. So, can someone help me with what in the heck I do if someone present with a gi bleed?
GI bleed can vary from mild anemia that shows up on a routine CBC. To the patient vomiting copious amounts of bright red blood and bloody stools.
Google nursing interventions for GI bleeders then come back here and ask more questions.
We have a lot of GI bleed patients come to my unit.
You'd look for pale skin (d/t blood loss), tachycardia, hypotension, abdominal pain, blood in vomit or stool, and check his labs. What are his H&H telling you? Make sure to check the trends of the labs and vitals as well. Trends tell you a lot about a patient. A patient may have a lower than normal H&H, but the trend shows that's the patient's norm due to chronic anemia. Or, the patient may have come in at 13, and now they're at 7.8. Trends will give you a much better picture than 1 lab.
As for what you do, have multiple IV access, administer blood (anticipate all types), prep for potential scope to see if the bleed is cauterized, possibly a Minnesota tube (if esophageal varices). Expect a pantoprazole and/or octreotide drip. Anticipate some calcium gluconate for every 4 units of blood given
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