GASTROINTESTINAL TRACT BLEEDING
Maria, a 48 year-old woman was transferred from emergency department (ED) to transitional care unit (TCU) with a diagnosis of probable gastrointestinal (GI) tract bleeding and abdominal pain. Patient c/o nausea and vomiting blood x2 weeks.
-Has a history of alcohol abuse
-Has a history of poorly controlled peptic ulcer disease due to non-compliance with treatment
-Is overweight, but recently lost 10 pounds
-Work as an admission coordinator at local junior college
-Live with her spouse, who was recently diagnosis with prostate cancer
-Recently experienced the death of a her mother from cardiac arrest
B/P = 77/41 HR 49 RR 16 T (tympanic) 37.9 (100.2) O2 Sats 98% RA
Lungs clear to auscultation, S-3 heart sound to auscultation
Diaphoretic, short of breath, anxious
NA 157 Serum K (potassium (3.0)
Hgb 7.6 HCT: 22.8 PLTs 138
RBC 3.32 WBC 11.6
Critical Thinking Questions:
1. Briefly explain the pathophysiology of the development of GI tract bleeding. What is the etiology associated with acute GI tract bleeding?
2. Identify common causes of GI tract bleeding and list predisposing factors specific to Maria.
3. Discriminate between the characteristics of upper and lower GI tract bleeding.
4. What complications did Maria experience?
5. Which factors determine whether blood products will be administered to a patient with GI tract bleeding?
6. Maria Hgb and Hct values dropped. Discuss the drop in Hgb and Hct values in relation to Maria blood loss.
7. If Maria continues to have active bleeding from the GI tract despite conservative management, what other medical procedures might be implement and why?