Nursing Care of Upper Gastrointestinal Bleeding with Esophagogastroduodenoscopy Treatments : A case study

Abstract

The purpose of this study was to provide a nursing care of upper gastrointestinal bleeding patient with esophagogastroduodenoscopy (EGD) treatments include injection, haemoclips, and mechanical methods such as endoscopic variceal ligation (EVL). The sample was a 51 year-old female patient presenting to the hospital with upper gastrointestinal bleeding with underlying disease include; cirrhosis, diabetes mellitus and hypertension. Data were collected during 19 to 22 September 2019. The nursing diagnosis in this case were as follows ; 1) risk for hypovolemic shock related to gastrointestinal bleeding, 2) anemia related to gastrointestinal bleeding and clotting mechanisms 3) anxiety related to lack of knowledge regarding EGD treatments 4) risk for complications related to high blood pressure 5) risk for infection related to diabetes mellitus 6) risk for re-bleeding in spite of these therapies and 7) anxiety related to illness and deficient knowledge. The results revealed that after EGD treatments, the patient did not meet the criteria for major bleeding, melena, dyspepsia and fever but the patient was still anxiety about gastrointestinal bleeding and varicose veins. Nursing interventions focus on patients' self-care and possible effects after EGD treatment. After 4 weeks follow up found some varicose veins in patient’s stomach. The physician was unable to provide treatment, therefore patient had referred to Maharaj Hospital for further appropriate treatment.

The results of this study indicated that laparoscopic nurses might have the knowledge and ability to assess patients with upper gastrointestinal bleeding who had underlying disease include high blood pressure, cirrhosis, and diabetes who sundered EGD treatments. Nurses also might assess cover the physical, mental, emotional, social well-being and economic aspects to make a plan for the nursing intervention and evaluation and then transferred medical information to the medical team continuously. In addition, the preparation of tools and equipments for EGD treatments could prevent the many risks that occurred while performing and after EGD treatments. Nurses in gastroscopy unit might possess the skills and competencies to help doctors operation and emergency life-saving equipments might be serviced. In order to achieve nursing outcomes and ensure patient safety without any complications and consistent with medical treatment.