NCLEX RN Practice Question # 902
NCLEX Examination.
Practice Question # 902.
nclex examination.
Gastrointestinal (GI) bleeding
Description:
- Bleeding that occurs at some area in the GI tract; classified into upper GI bleeding or lower GI bleeding.
- Causes of upper GI bleeding include peptic ulcer disease, stress-related erosive syndrome, esophageal or gastric varices, tearing of the GI tract, esophagitis, neoplasm, aortoenteric fistula, and angiodysplasia.
- Causes of lower GI bleeding include diverticulosis, angiodysplasia, neoplasm, inflammatory bowel disease, trauma, infectious colitis, radiation colitis, ischemia, aortoenteric fistula, and hemorrhoids.
- GI bleeding, or hemorrhage, is a potentially lifethreatening emergency condition.
Assessment
- Hematemesis
- Hematochezia
- Melena
- Decreased hemoglobin and hematocrit levels (may take 24 to 72 hours for the change to occur in acute blood loss)
Diagnosis
- Endoscopy once the client is hemodynamically stabilized
- Tagged red blood cell scanning, angiography, or both may be used to locate the source of bleeding.
Nursing Interventions
- The goal is to stop the bleeding and determine the cause of bleeding.
- Fluid resuscitation to achieve hemodynamic stability is necessary.
- Correction of hypercoagulability if indicated
- Therapeutic procedures to control or stop the bleeding
- Medications to suppress or neutralize gastric acids, including histamine-2 antagonists and proton pump inhibitors
- Note that these medications may place the client at risk for bacterial colonization and associated infections.
- Surgery may be used for a client who continues to be hemodynamically stable despite fluid resuscitation.