Upper gastrointestinal bleeding secondary to liver cirrhosis: A case report
DOI:
https://doi.org/10.55204/trc.v6i2.e720Keywords:
Upper Gastrointestinal Hemorrhage, Hepatic Cirrhosis, Hepatic Encephalopathy, Nursing Care Process, Older AdultAbstract
Variceal upper gastrointestinal bleeding (AKI) is one of the most critical and life-threatening complications of decompensated liver cirrhosis, requiring an agile and specialized clinical approach, particularly in the elderly. Objective: To apply the Nursing Care Process (PAE) to structure the comprehensive care of a 67-year-old patient hospitalized with variceal ADH, liver cirrhosis and unspecified hepatic encephalopathy in a Manabi Hospital, using a retrospective and descriptive clinical case study methodology, where the cephalocaudal assessment and the collection of information from the review of the clinical history were performed. Results: Five nursing diagnoses focused on the risk of hypovolemic shock, acute confusion, risk of aspiration, excess fluid volume and anxiety were prioritized, these interventions combined resuscitation with crystalloids, administration of lactulose/rifaximin, maintenance of the semi-Fowler position and strict control of the fluid balance, which allowed to achieve the hemodynamic stability of the patient, mitigate the signs of incipient encephalopathy (asterixis and bradypsychia) and ensure the successful performance of a diagnostic and therapeutic upper gastrointestinal video endoscopy without associated complications. It is concluded that the systematic application of the ECP and the integration of updated scientific evidence substantially optimize clinical decision-making and the prognosis of survival of the hepatopathic elderly in the face of episodes of massive gastrointestinal emergencies.Downloads
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