Bleeding gastrointestinal

The nurse checks the color of the stools. Black or dark stools or bright red blood in the stool may indicate gastrointestinal bleeding. The nurse reports to the primary care provider any change in the color of the stool. 

Before administering an NSAID, it is important for the nurse to determine if the patient has any history of allergy to aspirin or any otiier NSAID. The nurse determines if die patient has a history of gastrointestinal bleeding, hypertension, peptic ulceration, or impaired hepatic or renal function. If so, the nurse notifies the primary health care provider before administering an NSAID. 

These drug are used cautiously in patients with renal or hepatic disease, bladder obstruction, seizure disorders, sick sinus syndrome, gastrointestinal bleeding, and asthma Individuals with a history of ulcer disease may have a recurrence of the bleeding. 

A common problem associated with the administration of the bile acid sequestrants is constipation. Constipation may be severe and may occasionally result in fecal impaction. Hemorrhoids may be aggravated. Additional adverse reactions include vitamin A and D deficiencies, bleeding tendencies (including gastrointestinal bleeding) caused by a depletion of vitamin K, nausea, abdominal pain, and distention. 

May be preferred in patients whose risk of hospital-acquired pneumonia (HAP) is greater than upper gastrointestinal bleed. Data suggests a lower incidence of HAP when compared with H2-receptor antagonist... 

Management of Acute Nonvariceal Upper Gastrointestinal Bleeding"... 

Replace with 8-10 g albumin/L of ascitic fluid removed o Avoid large-volume paracentesis in patients with pre-existing hemodynamic compromise, acute renal insufficiency, active infection, or active upper gastrointestinal bleed. Cautious large-volume paracentesis in patients with tense... 

NSAIDs are one of the most widely used classes of medications in the United States, particularly in the elderly.4 More than 20,000 deaths occur in the United States per year as a direct result of adverse events related to NSAID use. Chronic NSAID ingestion leads to symptoms of nausea and dyspepsia in nearly half of patients. Peptic ulceration occurs in up to 30% of patients who use NSAIDs chronically, with gastrointestinal bleeding or perforation occurring in 1.5% of patients who develop an ulcer. NSAID-related peptic ulcers usually occur in the stomach duodenal ulcers are much less common. 

Previous peptic ulcer disease or upper gastrointestinal bleeding Cardiovascular disease and other comorbid conditions Multiple NSAID use (e.g., low-dose aspirin in conjunction with another NSAID)... 

FIGURE 19-4. Treatment algorithm for active gastrointestinal bleeding resulting from portal hypertension. (From Schianotd, Bodenheimer HC. Complications of Chronic Liver Disease. In Friedman SL, McQuaid KR, Grendell JH (eds.)... 

Gastrointestinal bleeding can result from erosion of intestinal blood vessels by pancreatic enzymes or as a result of thrombosis. 

NSAIDs Monitor patients for gastrointestinal distress, signs or symptoms of gastrointestinal bleeding, and hypertension and edema that may reflect renal dysfunction. Monitor CBC and serum creatinine as clinically indicated. 

Disintegration Dissolution Flowability Compressibility (Gastrointestinal bleeding)... 

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