Nursing care of Upper Gastrointestinal bleeding patients with Balloon Tamponade (Sengstaken-Blakemore tube) : Case study 2 case

Abstract

Background : The upper gastrointestinal bleeding is a suddenly occurring emergency, resulting from acute varicose veins in the esophagus and then acute rupture. Wich is a complication of liver cirrhosis and causing death. However, patients who have been temporarily stopped by using Balloon Tamponade Sengstaken-Blakemore tube (SB tube) along with providing accurate and medical care quickly, allowing patients to safe from crisis 

Objectives : To study disease progress, treatment, nursing diagnoses, nursing, and nursing outcomes.

Methods : This study was comparisons two case patients with Acute Uppers gastrointestinal bleeding with SB tube were admitted to Khon Kaen hospital between April and November 2017. The instrument employed in the study consisted of data from medical records, observation of patients as well as relative’s history, the use of nursing process and determining nursing diagnoses using the conceptual framework of Functional Health Pattern of Gordon

Results : The case study of 2 cases showed that they who vomited with fresh blood shock and were treated with Balloon Tamponade (SB tube). Findings included 1) Hypovolemic shock; 2) Hypoxia; 3) Bleeding Disorders; 4) Relatives’ anxiety; 5) Risk of acute respiratory failure; 6) Risk of re-bleeding 7) Uncomfortable due to wearing SB tube; 8) Risk for imbalanced nutrition 9) Decreasing the ability to take care in activity of daily living, and 10) Lack of readiness for discharge. In case study I, there was still the problem of acidosis and the risk of alcohol withdrawal, meanwhile the case study II showed an electrolyte imbalance along with unwell due to fever. The nursing is divided into three phases, namely 1) the critical phase focusing on keeping the patient’s safe from shock from bleeding; 2) the continuous phase emphasizing the prevention of complication of re-bleeding, infection and 3) the discharge phase to support the change in health behavior.

Suggestions : The nursing practice guidelines for the upper gastrointestinal bleeding patients with SB tube should be encouraged. The nursing professional competency should be developed for the upper gastrointestinal bleeding patients with SB tube

Keywords : Nursing care, Upper Gastrointestinal Bleeding, Sengstaken-Blakemore tube