CARE PLANS

GASTROINTESTINAL BLEEDING
NURSING CARE PLAN: GASTROINTESTINAL BLEEDING
NURSING DIAGNOSIS RESULTS INDICATOR MEASUREMENT SCALE TARGET SCORE
LABEL (PROBLEM)

Dysfunctional gastrointestinal
motility.
 abdominal noises 1. Seriously compromised Keep a:
Definition: 2. Substantially committed
 stool color
 Gastrointestinal  Stool volume 3. Moderately engaged
Increase, decrease, function 4. Slightly compromised
ineffectiveness or lack of  Color of aspirated
gastric contents 5. Uncommitted
peristaltic activity in the
 Amount of waste in
gastrointestinal system.
RELATED FACTORS (CAUSES): aspirated gastric
contents
Au mention to:
 Mucosal perforation
 bleeding peptic ulcer
 Pressure in a 1. Serious
compromised part of the 2. Substantial
 Abdominal pain
body (portal 3. Moderate
hypertension)  Abdominal
distention 4. Mild
5. None
DEFINING CHARACTERISTICS  blood in stool
(SIGNS AND SYMPTOMS):  digestive bleeding
 Hematemesis
 distended abdomen
 Change in noises
Intestinal
 Abdominal pain
 Nausea
 Threw up
 CARE PLANS
GASTROINTESTINAL BLEEDING

INTERVENTION: INTESTINAL CONTROL

ACTIVITIES

 Record the date of the last defecation

 Monitor bowel movements, including frequency, consistency, shape, and volume
 Monitor bowel sounds
 Report any increased frequency and/or high-pitched bowel sounds
 Report if there is decreased bowel sounds
 Monitor for signs or symptoms of diarrhea, constipation, and impaction
 Perform a fecal occult blood test, as appropriate
 CARE PLANS
GASTROINTESTINAL BLEEDING

INTERVENTION: INTESTINAL CONTROL

ACTIVITIES

 Record the date of the last defecation

 Monitor bowel movements, including frequency, consistency, shape, and volume
 Monitor bowel sounds
 Report any increased frequency and/or high-pitched bowel sounds
 Report if there is decreased bowel sounds
 Monitor for signs or symptoms of diarrhea, constipation, and impaction
 Perform a fecal occult blood test, as appropriate

INTERVENTIONS: PAIN MANAGEMENT

 CARE PLANS
GASTROINTESTINAL BLEEDING