Esophageal Varices Flashcards
what are esophageal varices?
swollen, fragile blood vessels in the esophagus
what are risk factors for esophageal varices?
- portal hypertenson, if the vein pressure is >20, it can cause esophageal varices
- cirrhosis and hepatitis
what are clinical manifestations of esophageal varices?
- hematemesis
- melena
- signs and symptoms of hypovolemic shock such as hypotension, tachycardia, and low H&H
- thrombocytopenia
what are priority interventions for these patients?
- AIRWAY!–> intubate before trying to stop bleeding
2. stop the bleeding by initiating IV access
what procedures can help treat esophageal varices?
balloon tamponade, banding, and TIPS
what is a balloon tamponade procedure look like?
tube goes from nose into stomach where the balloon is inflated to put pressure on the varices but it can only be inflated for 6 hours max because any longer then that will cause necrosis to esophagus
what is the purpose of banding esophageal varices?
banding cuts off circulation to the varices to stop the bleeding
what are TIPS for esophageal varices?
stent placement that redirects the blood flow
how can the nurse educate the patient on the risk for bleeding the esophageal varices?
- do not eat pointy food
- do not bear down while pooping (valsavar maneuvers)
- do not vomit, cough, or sneeze
what medications can be given for esophageal varices?
octreotide, vasopressin, and propranolol
what is the purpose of taking octreotide for esophageal varices?
decreases bleeding from the varices but does not affect BP
what is the purpose of taking vasopressin after giving fluids for esophageal varices?
reduces the amount of blood going into the liver which indirectly lowers portal HTN and variceal pressure
who is vasopressin contraindicated giving to?
cannot be given to patients with CAD because they already have vasoconstriction
what is the purpose of taking propranolol for esophageal varices?
used prophylactically for patients with liver issues. decreased portal hypertension and also decreases HR
