Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient. Three (3) resources after 2008 are required along with APA format.
GASTROINTESTINAL TRACT BLEEDING
Patient Profile
Maria, a 48 year-old woman was transferred from emergency department (ED) to transitional care unit (TCU) with a diagnosis of probable gastrointestinal (GI) tract bleeding and abdominal pain. Patient c/o nausea and vomiting blood x2 weeks.
Subjective Data:
-Has a history of alcohol abuse
-Has a history of poorly controlled peptic ulcer disease due to non-compliance with treatment
-Is overweight, but recently lost 10 pounds
-Work as an admission coordinator at local junior college
-Live with her spouse, who was recently diagnosis with prostate cancer
-Recently experienced the death of a her mother from cardiac arrest
Physical Examination:
B/P = 77/41 HR 49 RR 16 T (tympanic) 37.9 (100.2) O2 Sats 98% RA
Lungs clear to auscultation, S-3 heart sound to auscultation
Diaphoretic, short of breath, anxious
Laboratory Studies
NA 157 Serum K (potassium (3.0)
Hgb 7.6 HCT: 22.8 PLTs 138
RBC 3.32 WBC 11.6
Critical Thinking Questions:
1. Briefly explain the pathophysiology of the development of GI tract bleeding. What is the etiology associated with acute GI tract bleeding?
2. Identify common causes of GI tract bleeding and list predisposing factors specific to Maria.
3. Discriminate between the characteristics of upper and lower GI tract bleeding.
4. What complications did Maria experience?
5. Which factors determine whether blood products will be administered to a patient with GI tract bleeding?
6. Maria Hgb and Hct values dropped. Discuss the drop in Hgb and Hct values in relation to Maria blood loss.
7. If Maria continues to have active bleeding from the GI tract despite conservative management, what other medical procedures might be implement and why?
Title: Gastrointestinal Tract Bleeding: A Complex Pathophysiological Process
Introduction
Gastrointestinal (GI) tract bleeding is a critical medical condition that requires prompt assessment and intervention. In the case of Maria, a 48-year-old woman with a history of alcohol abuse, poorly controlled peptic ulcer disease, and recent weight loss, the pathophysiological process of GI tract bleeding is influenced by various factors. This essay delves into the pathophysiology of GI tract bleeding, its etiology, common causes, predisposing factors specific to Maria, complications, treatment options, and the impact of comorbidities on patient care.
Pathophysiology and Etiology
The development of GI tract bleeding involves complex pathophysiological processes. An acute GI tract bleed can be caused by various factors such as peptic ulcers, esophageal varices, Mallory-Weiss tears, or angiodysplasia. In Maria's case, her poorly controlled peptic ulcer disease due to non-compliance with treatment and recent weight loss could have contributed to the development of GI tract bleeding. Additionally, her history of alcohol abuse may have exacerbated the condition by causing gastric mucosal damage, leading to an increased risk of bleeding.
Common Causes and Predisposing Factors
Common causes of GI tract bleeding include peptic ulcers, gastritis, esophagitis, diverticulosis, and colorectal cancer. Predisposing factors specific to Maria include her history of poorly controlled peptic ulcer disease, recent weight loss, and alcohol abuse. These factors may have contributed to the development of GI tract bleeding in her case.
Upper vs. Lower GI Tract Bleeding
Upper GI tract bleeding typically presents with hematemesis (vomiting blood) or melena (black tarry stools), while lower GI tract bleeding is characterized by bright red or maroon blood in the stool. Maria's presentation of nausea and vomiting blood suggests upper GI tract bleeding.
Complications and Treatment
Maria's low hemoglobin (Hgb) and hematocrit (Hct) values indicate significant blood loss, leading to complications such as hypotension, tachycardia, and anemia. In such cases, the administration of blood products may be necessary to stabilize the patient's condition and improve tissue oxygenation.
Impact of Comorbidities on Patient Care
Maria's comorbidities, including alcohol abuse and poorly controlled peptic ulcer disease, complicate her management. The need for careful consideration of her overall health status and predisposing factors becomes crucial in formulating a comprehensive care plan.
Conclusion
In conclusion,
understanding the pathophysiology and etiology of GI tract bleeding is essential in providing effective care for patients like Maria. By recognizing the impact of comorbidities on the disease process and considering individual predisposing factors, healthcare providers can tailor treatment plans to address the specific needs of each patient. In Maria's case, a multidisciplinary approach that addresses her medical history, lifestyle factors, and emotional well-being will be crucial for achieving positive patient outcomes.
References
Sung JJY, Kuipers EJ, El-Serag HB. Systematic review: the global incidence and prevalence of peptic ulcer disease. Aliment Pharmacol Ther. 2009;29(9):938-946.
Laine L, Yang H, Chang SC, et al. Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009. Am J Gastroenterol. 2012;107(8):1190-1195.
Strate LL, Ayanian JZ, Kotler G, Syngal S. Risk factors for mortality in lower gastrointestinal bleeding. Clin Gastroenterol Hepatol. 2008;6(9):1004-1010.
Note: The above references have been cited in APA format for your convenience.