Nursing care in patients with upper gastrointestinal bleeding : 2 cases study

Abstract

Abstract

            This study compared nursing care for patients with upper gastrointestinal bleeding conducted in the Acute care surgery intensive care unit, Roi Et Hospital between September - November 2023. In the purposively selected sample, there were 2 patients with upper gastrointestinal bleeding. Tools used Case record and Functional Health Pattern Assessment form; collected data using interviews, observations, conversations, and document. The results of the study in both cases were that the chief complaints were hematemesis and melena. Diagnosis of upper gastrointestinal bleeding with shock, They had an endoscopy finding Case 1 found a bleeding gastric ulcer and stopped bleeding using an Adrenalin injection and Case 2 found Esophageal Varices grade 3 stopped bleeding using a banding ligation procedure. The patient has a nursing diagnosis of 4 stages as follows: 1) Emergency crisis stage, including impaired gas exchange, low cardiac output, risk for bleeding and difficulty stopping, risk of danger during endoscopy of the upper digestive tract, and powerlessness; 2) the semi-critical stage, imbalanced nutrition: less than body requirements; 3) recovery stage, discomfort due to severe illness and critical treatment, and 4) the discharge stage, the possibility of re-bleeding. which problems were resolved in Case 1, discharged on 31 Oct. 2023, a total of 18 days and Case 2,  discharged on 28 Oct. 2023, a total of 6 days. Therefore, nursing practice guidelines for patients with upper gastrointestinal bleeding should be developed to indicate quality nursing services.      

Keywords: Nursing care, Upper gastrointestinal bleeding