20 hours ago Bleeding Esophageal Varices Definition: Esophageal varices develop in the majority of patients with cirrhosis. Varices are varicosities that develop from elevated pressure in the veins that drain into the portal system. They are prone to rupture and often are the source of massive hemorrhages from the upper GI tract and the rectum. In addition, blood clotting abnormalities, … >> Go To The Portal
Bleeding Esophageal Varices Definition: Esophageal varices develop in the majority of patients with cirrhosis. Varices are varicosities that develop from elevated pressure in the veins that drain into the portal system. They are prone to rupture and often are the source of massive hemorrhages from the upper GI tract and the rectum. In addition, blood clotting abnormalities, …
Rationale: The therapeutic action of H2 receptor blockers in patients with esophageal varices is to prevent irritation and bleeding from the varices caused by reflux of acid gastric contents. Although ranitidine does decrease the risk for peptic ulcers, reduce nausea, and help prevent aspiration pneumonia, these are not the primary purpose for H2 receptor blockade in this patient.
Which medication is used to decrease portal pressure, halting bleeding of esophageal varices? a) Vasopressin b) Citmetidine c) Spironolactone d) Nitroglycerin
Question Which medication is used to decrease portal pressure, ... Clay - colored or whitish. Question A client with cirrhosis has a massive hemorrhage from esophageal varices. Balloon tamponade is used temporarily to control hemorrhage and stabilize the client. In ... Course Hero member to access this document. Continue to access. End of ...
Beta blockers decrease pressure inside of the varices, which can reduce the risk of bleeding by 45 to 50 percent [1]. There are several forms of beta blockers. The two most commonly used beta blockers for prevention of bleeding are propranolol (Inderal) and nadolol (Corgard).
Drugs such as octreotide (Sandostatin) and vasopressin (Vasostrict) slow the flow of blood to the portal vein. The drug is usually continued for up to five days after a bleeding episode.
Pharmacologic therapy for portal hypertension includes the use of beta-blockers, most commonly propranolol and nadolol. Brazilian investigators have suggested that the use of some statins (eg, simvastatin) may lower portal pressure and potentially improve the liver function.
Patients with a high risk of bleeding may undergo preventive treatment with the same techniques that are used to stop bleeding. The most commonly used technique is variceal ligation. Bleeding from esophageal varices is an emergency that requires immediate treatment.
By slowing the heart rate and widening the blood vessels, beta-blocker medicines such as propranolol and nadolol appear to lower the blood pressure in varices that bypass the liver. In people who have esophageal varices, beta-blockers have been shown to reduce the risk of having a first episode of bleeding.
Octreotide reduces portal and variceal pressures as well as splanchnic and portal-systemic collateral blood flows [2]. It also prevents postprandial splanchnic hyperemia in patients with portal hypertension [3] and lowers gastric mucosal blood flow in normal and portal hypertensive stomachs [4].
By slowing the heart rate and widening the blood vessels, beta-blocker medicines such as propranolol and nadolol appear to lower the blood pressure in varices that bypass the liver. In people who have esophageal varices, beta-blockers have been shown to reduce the risk of having a first episode of bleeding.
Somatostatin and its analogue octreotide have been used for two decades to treat oesophageal variceal haemorrhage. The drug was introduced because of its capacity to decrease portal venous pressure without major side effects.
Octreotide decreased portal pressure in cirrhotic patients by inhibiting HSC contractility by decreasing intracellular Ca2+ concentration via stimulation of all SSTRs on HSCs.
Currently, no treatment can prevent the development of esophageal varices in people with cirrhosis. While beta blocker drugs are effective in preventing bleeding in many people who have esophageal varices, they don't prevent esophageal varices from forming.
Vasopressin has been used for 25 years to control bleeding from esophageal varices. Its efficacy is believed to be due to a direct vasoconstrictor activity on splanchnic arterioles and precapillary sphincters, with secondary reduction in portal venous blood flow and pressure.
Both nonselective ß-blocker therapy and EVL were effective in decreasing the incidence of hemorrhage of esophageal varices and mortality associated with hemorrhage.
The health care provider inserts the tube and verifies the position. The esophageal balloon is deflated every 8 to 12 hours to avoid necrosis, but if the gastric balloon is deflated, the esophageal balloon may occlude the airway. 19.
A portocaval shunt is considered for a patient with cirrhosis following an episode of bleeding esophageal varices. The nurse plans to teach the patient that this procedure. a. is likely to improve the patient's life expectancy. b. will increase the risk of hepatic encephalopathy.
5. A homeless patient with severe anorexia, fatigue, jaundice, and hepatomegaly is diagnosed with viral hepatitis and has just been admitted to the hospital. In planning care for the patient, the nurse assigns the highest priority to the patient outcome of
Rationale: NG suction and NPO status will decrease the release of pancreatic enzymes into the pancreas and decrease pain. Although bowel sounds may be hypotonic with acute pancreatitis, the presence of bowel sounds does not indicate that treatment with NG suction and NPO status have been effective.
Rationale: Pancreatic enzymes are released when the patient eats. NG suction and NPO status decrease the release of these enzymes. Fluid and electrolyte imbalances will be caused by NG suction and require that the patient receive IV fluids to prevent this.
The nurse does not need to talk with the doctor before giving the spironolactone, although the health care provider should be notified about the low potassium value. The furosemide will further decrease the patient's potassium level and should be held until the nurse talks with the health care provider. 14.
Rationale: Therapy with ribavirin and -interferon may decrease lymphocyte counts. The other laboratory values should not be changed by the drug therapy.
Question Ammonia, the major etiologic factor in the development of encephalopathy, inhibits neurotransmission. Increased levels of ammonia are damaging to the body. The largest source of ammonia is from: The digestion of dietary and blood proteins.
Balloon tamponade is used temporarily to control hemorrhage and stabilize the client. In planning care, the nurse gives the highest priority to which goal?
Rationale: To palpate the liver, the examiner places one hand under the right lower rib cage and presses downward with light pressure with the other hand. The liver is not on the left side or in the right lower abdominal quadrant.
Fector hepaticus is a sweet, slightly fecal odor to the breath and not associated with a motor disturbance. Skin changes associated with liver dysfunction may include palmar erythema, which is a reddening of the palms, but is not a flapping tremor.
Rationale: Decreased production of several clotting factors may be partially due to deficient absorption of vitamin K from the GI tract. This probably is caused by the inability of liver cells to use vitamin K to make prothrombin. This bleeding risk is unrelated to the roles of glucose, bile salts, or albumin.
The nurse would not teach the patient to measure drainage from a T-tube as the patient would;t go home with a T-tube. The nurse may teach the patient about the need to exercise or what the signs of liver dysfunction are, but the nurse would not stress these topics over the immunosuppressive drug regimen.
Coagulation tests should be performed, but electrolyte analysis is not necessary. A nurse is caring for a patient with hepatic encephalopathy. The nurse's assessment reveals that the patient exhibits episodes of confusion, is difficult to arouse from sleep and has rigid extremities.
Because of this safety and efficacy profile, octreotide is considered the preferred treatment regimen for immediate control of variceal bleeding. Vitamin K and albumin are not administered and heparin would exacerbate, not alleviate, bleeding. A nurse is caring for a patient with hepatic encephalopathy.
A portocaval shunt is considered for a patient with cirrhosis following an episode of bleeding esophageal varices. The nurse plans to teach the patient that this procedure. a. is likely to improve the patient's life expectancy. b. will increase the risk of hepatic encephalopathy.
5. A homeless patient with severe anorexia, fatigue, jaundice, and hepatomegaly is diagnosed with viral hepatitis and has just been admitted to the hospital. In planning care for the patient, the nurse assigns the highest priority to the patient outcome of
A patient with cancer of the liver has severe ascites, and the health care provider plans a paracentesis to relieve the fluid pressure on the diaphragm. To prepare the patient for the procedure, the nurse. a. asks the patient to empty the bladder. b. positions the patient on the right side.
Rationale: Therapy with ribavirin and -interferon may decrease lymphocyte counts. The other laboratory values should not be changed by the drug therapy.