Stomach Disorders: Hiatal Hernia Flashcards

1
Q

What is the esophageal hiatus?

A

• An opening in the diaphragm through which the esophagus and the vagus nerve pass.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a hiatal hernia?

A

• This occurs when a portion of the upper part of the stomach bulges through the diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some causes of hiatal hernia?

A
  • Obesity
  • Weakened diaphragm
  • Pregnancy
  • Ascites
  • Tumors
  • Heavy lifting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the general s/s of hiatal herniation?

A

• Same as GERD w/ the exception of the rolling hernia which adds fullness and difficulty breathing to the list

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two types of hiatal hernia?

A
  • Sliding
  • Paraesophageal (rolling)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a sliding hiatal hernia?

A
  • Occurs when the stomach and the lower part of your esophagus slide up into your chest through the diaphragm.
  • This is the most common type of hiatal hernia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a paraesophageal hernia?

A
  • Occurs when the esophagus and stomach stay where they should be, but part of the stomach squeezes through the hiatus to sit next to the esophagus.
  • This is more dangerous as:
    • The stomach can become squeezed and lose its blood supply
    • It can apply direct pressure against the heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the s/s of a sliding hiatal hernia?

A
  • Similar to those w/ acid reflux/GERD
  • Worsens after meals or in supine position
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the s/s of a rolling hernia?

A
  • Feelings of fullness after eating
  • Breathlessness or suffocation
  • Usually no reflux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What diagnostic tests are used for hiatal hernia?

A
  • Barium swallow
  • Upper endoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the tx for a sliding hiatal hernia?

A
  • Similar to GERD
  • Weight loss
  • No bent lifting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the tx for a rolling hernia?

A
  • Surgical
    • Laparoscopic Nissen Fundoplication (LNF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does a Laparoscopic Nissen Fundoplication (LNF) help prevent/resolve paraesophageal hernia?

A

• The procedure wraps part of the stomach around the cardiac sphincter reinforcing it and making the area larger and more difficult to penetrate through the hiatus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are two types of drugs that can help manage s/s of hiatal herniation?

A
  • Antacids
  • H2R Blockers (such as Ranitidine (Zantac))
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Post LNF nursing management will include:

A
  • Typical surgical post-op care
  • NG tube management
  • Post-op teaching for self-care and prevention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the nursing education provided for hiatal hernia patients?

A
  • Small frequent meals
  • Minimize the amount of liquid
  • Avoid anticholinergic drugs
  • Lose weight
  • Do not recline for one hour after eating
  • Sleep with head of bed elevated
17
Q

What are some possible complications of a hiatal hernia?

A
  • Severe GERD (gastroesophageal reflux disease)
  • Lung problems or pneumonia because stomach contents have moved up into your esophagus and into one or both lungs.
  • Strangulation of the hernia, cutting off blood flow to your stomach (medical emergency)
18
Q

What are some possible post LNF complications?

A
  • Gas bloat syndrome
  • Inability to belch and vomit
  • Dysphagia