Final answer:
The nurse should closely monitor the client's vital signs and renal output, watch for signs of ongoing bleeding or renal function impairment, and be prepared for further interventions. NSAIDs like ibuprofen can cause GI bleeding and kidney damage, requiring vigilant nursing care to prevent shock and further complications.
Step-by-step explanation:
The intervention a nurse should include for a male client with impaired renal function and GI bleeding is close monitoring of the client's vital signs and renal output after the infusion of IV fluids and a blood transfusion. Ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), can cause gastrointestinal bleeding and kidney damage, especially in individuals with compromised renal function or at higher risk due to age or other conditions. Given the client's current blood pressure of 100/70 and renal output of 20 ml/hour, the nurse should monitor for signs of ongoing bleeding, changes in urine output, or any indications of worsening renal function, shock, or other complications while continuing to provide supportive care.
It is crucial for the nurse to understand the implications of NSAID-induced renal impairment. With renal output at 20 ml/hour, this is particularly concerning, as the kidney's ability to cope with systemic blood pressure changes can be compromised when mean arterial pressure falls below adequate levels to maintain glomerular filtration, which can lead to shock and further renal damage.
Therefore, the nurse must monitor for changes in the patient's condition, administer medications as prescribed, and possibly prepare for further interventions if the patient's situation declines. Alerting the physician to any negative trends is imperative, as time-sensitive decisions may need to be made regarding the patient's ongoing management.