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UpperGastricBleeding
n/a
Question | Answer |
---|---|
Upper Gastric Bleeding | Bleeding severity depends on the origin |
Hematemesis | Bright red blood not in contact with gastric contents. Coffee ground appearence and in contact with stomach for some time. |
Melena | Abnormal black tarry stools. |
Occult Blood | Small amounts of blood in gastric secretions, vomit or stools. |
Massive upper gastric bleeding | 1500 ml of blood loss. 25% loss of blood of the intravascular blood volume. |
Causes of Upper Gastric Bleeding: DESK | Drug induced, Esophagus,Stomach & System Diseases. |
Drug-Induced: CNS | Corticosteriods, NSAIDS & Salicylates. |
Esophagus: MEE | Mallory-Weiss Tear, Esophageal varices and esophagitis. |
Stomach & Duodeum: I got my GPS, Horaah!!! | Gastric Cancer, peptic ulcer, polyps, stress ulcers and hemorrhagic gastritis. |
Systemic Diseases: A Bad Renal and liver failure | Blood dyscrasias, liver and renal failure. |
S & SX: Rick with a Gun | Respiratory, integumentary, cardio, GI, Urinary & neuro. |
Respiratory: Rest and relaxation | Rapid respiration. |
Integumentary: Pens are cool. | Nailbed, edema, cool skin, pale |
Cardio: | Increased heart rate, decreased blood pressure, slow capillary refill. |
Urinary: Urinary cup is low and concentrated | Low and concentrated urine. |
Neuro: RAD | Restless, agitated and decreased LOC. |
Care: Assessment | History: possible causes of GI bleeding. Physical assessment: Cardio, respiratory & GI body sytems. |
Care: Management | 2 IV lines for fluid and blood replacement. Oxygen supplement to increase O2 saturation. Indwelling catheter and monitor input hourly. Nasgastric tube to aspirate blood and central venous line. |
DX: Blood chemistry | CBC, BUN, Creatinine ABG's, BS, PTT, PT, Type & X Match, liver enzymes, blood in stool & urine. |
DX: Endoscopy | To identify and stop the bleeding. Needles with drugs, clips and heated probes to stop the bleeding and remove clots. |
DX: Angiography | Identify the bleeding. Inserted left gastric superior mesenteric artery. |
Drug Therapy: Decrease bleeding | Vasopressin drugs & epinephrine drugs. |
Drug Therapy: Decrease acid | H2 Receptor Blockers and proton pump inhibitors. |
Drug Therapy: Neutrilizes acides | Antacids. |