NSG 210 Test 3 Study Guide

Has replaced sclerotherapy as the tx of choice for

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Unformatted text preview: tests: may include LFT’s Tx: includes drug therapy, balloon tamponade, endoscopic therapy, variceal band ligation, TIPS procedure & surgery  ­Drug Therapy: includes a beta ­blocking agent, antibiotics & vasoactive drugs When pts are admitted, they are usually given an antibiotic such as Noroxin or Cipro for SBP prevention. Noroxin is #1 drug of choice for this. Vasopressin may be the initial mode of therapy in urgent situations. VS & presence/absence of blood in the gastric aspirate indicate effectiveness. I&O’s & electrolyte levels should be monitored b/c Vasopressin may cause hyponatremia or have an antidiuretic effect. Vasopressin is contraindicated in pts w/ hx of CAD. Somatostatin & octreotide (Sandostatin) are other vasoactive drugs reported to decrease bleeding from varices but lack the vasoconstrictive effects of Vasopressin. They are used mainly in the management of active hemorrhage. Monitor cardiac status, B/P, apical pulse & look for s/s of stroke Beta ­blocking agents such as propranolo (Inderal) help decrease portal pressure & are the most common meds used to prevent the first bleeding episode & to prevent rebleeding. They can’t be used once hemorrhage occurs.  ­Balloon Tamponade: used to control hemorrhage for as short term as possible. A balloon is first inserted & inflated in the stomach & confirmed w/ x ­ray. If bleeding continues, another balloon is inserted & inflated in the esophagus. When bleeding stops, the esophageal balloon is deflated first & removed. The pt is monitored for recurrent bleeding for several hours. If bleeding doesn’t occur after several hours, the gastric balloon is deflated & r...
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This document was uploaded on 03/29/2014.

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