About
Varicosities with or without bleeding that develop in the esophagus secondary to cirrhosis and increased pressure on the portal systemic veins.
Assess
- Hematemesis, blood in the stool, history of alcoholism, fatigue, tachycardia, hypotension
Complications
- Bleeding, hepatic encephalopathy, alcohol withdrawal, cardiac arrest, death
Diagnosis
- Decreased cardiac output related to acute bleeding.
- Fluid volume deficit related to hemorrhage.
- Nutrition less than body requirements related to chronic alcoholism, necessity for NPO status.
- Risk for injury related to mental status changes.
Goals
- The client will maintain adequate fluid balance.
- The client will remain free from injury.
- The client will identify activities to minimize complication pre- and post-operatively.
- The client will have an acceptable blood pressure measurement reading.
Interventions
- Assess and monitor vital signs frequently.
- Assess cardiac status and monitor telemetry.
- Monitor labs especially CBC and electrolytes.
- Monitor for changes in mental status and signs and symptoms of acute alcohol withdrawal.
- Teach client what to expect before, during, and after procedures/ surgery to control bleeding.
- Monitor strict intake and output.
- Administer vasopressin as indicated by physician.
- Prepare client for surgery as indicated by physician.
- Maintain a patent IV line and administer fluids as indicated by physician.
- Insert an NG tube as indicated by physician to maintain esophageal rest.
- Administer blood transfusions as indicated by physician.
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