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Terms in this set (15)
Dilated, congested & twisted veins in submucosa of the esophagus. A form of varicose veins in the esophagus. Distended & totuous vessels that can rupture secondary to coughing sneezing, vomiting or ingestion of food high in roughage. Ruputerd & bleeding esophageal varices are medical emergences.
Resistance to normal venous drainage of the liver into the portal vein
Dilated & Tortuous Veins
Are at high risk for rupture if portal circulation pressure rises.
There is persistent increased pressure in the portal vein that causes veins to balloon outward. Veins experiences increase pressure & beome distended with blood, the vessels enlarge & varices develop. Ballooning of blood vessels (veins) may cause vessels to rupture causing: vomiting of blood, tarry black stools. If large volume of blood is lost sign of shock will develop. Due to increased resistance or obstruction to blood flow the: blood flow back into the spleen causing splenomegaly.
Effects of esophageal varices
Varices rupture & bleed in response to ulcertaion & irritation
Factors that produce ulceratiion: alcohol ingestion, swallowing poorly masticated food, increased intraabdominal pressure caused by: n/v, straining at stool and lifting heavy objects
Control bleeding, prevent complications
Lavage-ice normal saline to promote vasoconstriction of the varice, blood trasfusions with fresh whole blood, vitamin K therapy-for clotting, use of balloon tamponade-to control hemorrhage. To prevent complication of hemorrhage: sengstake-blakemore tube
Intra arterial or IV vasopressin (Pitressin) therapy infusion
To induce vasoconstriction and reduce bleeding. Usually given when cardiac monitor is in place: due to constrictive effects of this medication on the coronary arteries, continous EKG & BP monitorig is essential. Given intermittently of continous infusion via IV pump, administered with caution to clients with cardiac disease because of vasoconstriction, decreased HR & decreased coronary artery blood flow.
Reduces detrimental effects of vasopressin while enhancing its benefical effects. Give with vasopressin to counter act side effects of vasopressin.
Decompress esophageal varices and help maintain optimal portal perfusion
Subjective: fatigue and weakness. Objective: hematemsis-bloody vomitus, either bright red (indicate fresh blood) or "coffee ground" (indicate older blood that has been in the stomach long enough for gastric juices to act on it) melena (occult blood in stool) peripheral edema
Idicators of probable esophageal varices
Hematest of vomitus-postive, PT-prolonged
Stabilize client & manage airway-maintain clients airway & prevent aspiration of blood during treatment, monitor vs & LOC, monitor and provide care of Sengstake Blackmore tube, closely monitor and asses for the possible emergency life threatening complications.