Lower GI Bleed #2

Lower GI Bleed #2

1. Lower GI Bleed S/S: abdominal pain, black, tarry stool, dizziness, fatigue, shortness of breath, chest pain, vomiting, and weight loss.

2. Labs: CBC to check WBC, Hgb, Hct, platelets; liver function tests, PT/INR, and stool testing.

3. Patho: this is a result of bleeding between the small intestine, large intestine, rectum, or anus.

4. Causes: diverticulitis, IBS, tumors, colon polyps, hemorrhoids, anal fissures, cancer, and chronic constipation. Other causes could be from long-term Prednisone use and long-term use of NSAIDs.

5. Vitals: assess oxygen levels and keep continuous watch on those levels; watch blood pressure for lows. Perform a head to toe assessment to make sure there are no complications with heart & lungs and neurological system.

6. Labs: ABGs: pH=7.47, PaCo2=33, PaO2=65, HCO3=23. WBC: 4300. RBC: 4.0. Hgb: 7.8. Hct: 23%. Platelets: 208.

   • ABGs show respiratory alkalosis & hypoxemia. WBC is on the lower end which can indicate infection. RBC is still in the normal range. Hgb & Hct is too low and would require a blood transfusion and likely has been bleeding for a while. Platelets are in the normal range.