PUD w/ Active Bleed

[goemom]

Our instructor said she would give us a set of VS on a pt with PUD and an active bleed then we would have to determine our first intervention. In class we talked about making the patient NPO, checking CBC, type & crossmatch blood, NG tube to prevent coughing up of blood, use ice lavage to cause vasoconstriction, IV fluids and prepare for possible blood transfusion. But can I do any of these without a DO? If not what else? High fowlers?

[Esme12, ASN, BSN, RN]

PUD....Peptic ulcer disease?

[goemom]

Yes with active bleed.

[Esme12, ASN, BSN, RN]

IS this for a care plan? or a simulation/scenario situation. Your interventions will depend on your vital signs.

Always think ABC. What are your vital signs? Is this patient going into shock? If your patient has a low B/P are you going to place them in high fowlers?

Use your thinking cap....look up Peptic Ulcer disease. Look up GI bleeding. Look up Shock. Then develop a plan on how to care for that patient.

[nurseprnRN, BSN, RN]

Our instructor said she would give us a set of VS on a pt with PUD and an active bleed then we would have to determine our first intervention. In class we talked about making the patient NPO, checking CBC, type & crossmatch blood, NG tube to prevent coughing up of blood, use ice lavage to cause vasoconstriction, IV fluids and prepare for possible blood transfusion. But can I do any of these without a DO? If not what else? High fowlers?

You don't need a Doctor of Osteopathy for any of this.

If your instructor is asking you what components of a medical plan of care to prepare for, then it's pretty much all of the above. None of these (except raising the head of the bed) would be part of a nursing plan of care, although a nurse would be legally obligated to implement most of them as part of a medical plan of care. (You can sit 'em right up, though, if VS permit, to improve ventilation and decrease the mess you'll be dealing with when the vomiting starts. :) )

If she's looking at your ability to prioritize these medical interventions, assuming they are all part of the medical plan of care, what do you think would be a good priority order, and why?

(An NG tube will not "prevent coughing up blood." )