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UpperGastricBleeding

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QuestionAnswer
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.
Created by: libbygal_77
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