Postop care focuses on preventing respiratory complications maintaining fluid

Postop care focuses on preventing respiratory

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Postop care focuses on preventing respiratory complications, maintaining fluid and electrolyte balance, and preventing infections. Procedures are performed in an outpatient setting unless the patient is at risk for complications. Not many patients experience complications which include gastric or esophageal injury, splenic injury, pneumothorax, perforation, bleeding, infection, and pnuemonia. Since most procedures are done laparoscopically the risk for respiratory complications is reduced. If an open high abdominal incision is used, respiratory complications can occur so monitor respiratory rate and rhythm, pulse rate and rhythm, and signs of pneumothorax. Have the patient cough and deep breathe patients may require medications to prevent nausea and vomiting and to control pain. Measure and record the intake and output. When peristalsis returns only get fluids initially After surgery, reflux symptoms should decrease however recurrence is possible. In the first month after surgery the patient may report mile dysphagia caused by edema but it should resolve. Hiatal Hernia: Herniation of a portion of the stomach into the esophagus through an opening, or hiatus, in the diaphragm. The most common abnormality found on x-ray examination of the upper G.I. tract. Common in older adults in a car more often in women. Etiology and Pathophys:
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Factors that increase intra-abdominal pressure may predispose patients to develop a hiatal hernia these include obesity, ascites, tumors, intense physical exertion, and heavy lifting on a continual basis Clinical Manifestations and complications: Complications that may occur with hiatal hernia include Gerd, esophagitis, hemorrhage from erosion, stenosis, ulceration of the herniated portion of the stomach, strangulation of the hernia, and regurgitation with tracheal aspiration. Diagnostic Studies : And esophagram (barium swallow) may show the protrusion of gastric mucosa through the esophageal hiatus. Endoscopic visualization of the lower esophagus provides information on the degree of mucosal information or other abnormalities. Nursing and Interprofessional Management: Hiatal Hernia Teach the patient to reduce intra-abdominal pressure by eliminating constricting garments and avoiding lifting and straining. Surgical approaches to hiatal hernia’s can include reduction of the herniated stomach into the abdomen, herniotomy (excision of the hernia sac), anti-reflux procedure, and gastropexy(attachment of the stomach subdiaphragmatically to prevent reherniation) The goals are to reduce the hernia, provide an acceptable LES pressure and prevent movement of the gastroesophageal junction. Surgery usually done laproscopically by either Nissen or toupet.
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  • Winter '17
  • ellis
  • clinical manifestations, Gastroesophageal reflux disease, HCL Acid

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