Nursing of patients with gastrointestinal bleeding, nursing problems of gastrointestinal bleeding?

The nursing measures for upper gastrointestinal bleeding mainly include the following aspects:

1. Daily monitoring.

Observe the changes in the patient's vital signs, including blood pressure, body temperature, pulse, respiration, etc., and use an ECG monitor to monitor if possible;

Observe the color, quality, and quantity of the patient's consciousness, peripheral circulation, urine output, hematemesis or hematochezia, etc.; Observe whether the patient has dizziness, palpitations, cold sweats and other shock manifestations.

2. Bleeding period nursing.

1. The patient is on absolute bed rest to prevent bleeding again;

2. Quickly establish venous access when bleeding, cooperate with doctors to timely match blood and prepare blood, etc., and help patients take the lateral or semi-recumbent position when vomiting blood;

3. For irritable patients, they should be explained and comforted in time to eliminate tension and fear;

4. Replace the polluted bedding in time;

5. Pay attention to the warmth of the patient.

3. Dietary care.

1. Strict prohibition of eating and drinking during bleeding;

2. 2-3 days after the bleeding stops, you can eat an appropriate amount of sugar and salt water, liquid food, rice oil, rice soup, etc.; After 2-3 liquid diets, it can be changed to semi-liquid diets;

Soft food can be eaten after 3-5 days of eating.

The clinical manifestations of gastrointestinal bleeding depend on the volume of blood, the rate of bleeding, the location and nature of bleeding, and the patient's age and ability to compensate circulatory function. When the symptoms are mild, there may be no manifestations, and when the bleeding is obvious, hematemesis, melena, and hematochezia may be seen. Anemia may be associated with continued exacerbations.

Volume depletion, and even shock.

It is recommended to go to the relevant hospitals and outpatient departments to follow the doctor's advice, everyone is similar, but there is a certain gap, or follow the doctor's examination and follow the recommendations for care.

Symptoms of gastrointestinal bleeding: 1. The typical manifestation of pain is that it will produce pain, and often patients will have more severe colic before or after eating. 2. If the symptoms of gastrointestinal bleeding in patients with hematemesis are more serious, and the bleeding site is located above the digestive tract, it is very likely that the phenomenon of hematemesis will occur, and the amount of hematemesis varies greatly according to the severity of the patient's condition.

3. If the patient's gastrointestinal bleeding site is located below the digestive tract, and the amount of bleeding is relatively small, then black stool will occur. 4. Anemia due to long-term chronic or acute bleeding, so most patients with gastrointestinal bleeding will have the problem of anemia, paleness, weakness and cold hands and feet.

Gastrointestinal bleeding nursing diagnosis and nursing measures Nursing diagnosis Body fluid insufficiency: It is associated with excessive fluid loss due to hematemesis, melena, and insufficient fluid intake. Activity without stamina:

Associated with hypovolemia. Abnormal bowel movements: associated with upper gastrointestinal bleeding.

Anxiety: Alienation from the environment, health is at risk.

Care measures for patients with gastrointestinal bleeding include: ().

a.Sit upright to prevent suffocation.

b.Pay attention to psychological lapping care (correct answer).

c.Actively make up for the congested volume of the hood (correct answer).

d.Closely observe the patient's mental status, vital signs, and hourly urine output (correct answers) eCooperate with the doctor to stop the bleeding effectively (correct answer).

1) Ask the patient to lie quietly in bed to do psychological care, stabilize the mood, and take the lower limbs to raise the high position. Keep the airway open, take oxygen if necessary, and avoid asphyxia caused by hematemesis.

2) Diet: patients with hematemesis should be fasted, only a small amount of tarry stool, can enter the liquid, the stool turns yellow to semi-liquid.

3) Check the blood type and do a good cross-match.

4) Blood volume supplementation: rapid intravenous infusion. The amount of fluid given is based on the amount of blood loss, and dextran should not exceed 1000ml within 24 hours.

Adequate whole blood should be transfused in a timely manner to restore volume and effective circulation. It is better to keep hemoglobin not less than 90 100g l. Fresh blood should be used, and care should be taken to avoid pulmonary edema caused by excessive infusion and blood transfusion.

5) For gastric bleeding, gastric cooling and hemostasis can be performed, and gastric lavage can be performed with ice saline with hemostatic agent. For patients with esophageal variceal bleeding, use three-lumen or four-lumen balloon tube compression to stop bleeding.

6) Pay attention to oral care, and rinse your mouth with warm water after vomiting blood.

7) Carefully observe the condition: pay attention to whether there is hematemesis and blood in the stool; changes in general condition and mental status; Repeat vital signs and keep records; whether the limbs are warm, ** and the color of the nail bed; Peripheral venous hyperfibrillation is not a jugular venous distension; Hourly urine output is recorded; Regular re-examination of red blood cell count, hemoglobin, hematocrit, and blood urea nitrogen; Central venous pressure if necessary; Accurately record the amount of water in the 24-hour outlet.

Principle of treatment: bed rest, fasting. Closely monitor for changes.

Use sedatives appropriately (contraindicated in patients with cirrhosis). For the use of hemostatic drugs, norepinephrine 8mg can be added to 1000ml of water in divided oral or gastric tube injections. Patients with esophageal vein rupture and bleeding are injected intravenously or intravenously instilled vasopressin 10u in 5 glucose 200ml, slowly intravenous infusion, and the daily dosage should not exceed 3 times to reduce portal pulse pressure and have hemostatic effect on esophageal and gastric variceal bleeding.

Three- or four-lumen balloon tube pressure can be used to stop bleeding. Fluids and blood transfusions are given to prevent shock and electrolyte balance disturbances. Prevent complications.

Surgery if necessary.