ASSALAMMUALLAIKUM WR.

WB
 ESOPHAGEAL VARICES
GROUP 6
Weni Dwi Cahyani 21117130
Widya 21117132
Windah Anisyah 21117134
Wisma Wardani 21117136
Yola Alfina 21117138
Yosa Nanda Fermata 21117140
Yuti Sartika 21117142 STIKes MUHAMMADIYAH PALEMBANG
2018/2019
 Definitions
Condition esophageal varices is usually associated with cirrhosis
and portal hypertension in which the small veins in the esophagus
becomes distended and ruptured as a result of increased pressure in
the portal system.
Esophageal varices is a disease characterized by abnormal
enlargement of the veins in the lower esophagus. Esophageal varices
occurs when blood flow to the heart is blocked. Your stream will look
the other way, ie to the blood vessels in the esophagus, stomach, or
rectum are smaller and easier to break.
 Etiology
Oesophageal varices is usually a complication of liver
cirrhosis. Cirrhosis is a disease characterized by the
formation of scar tissue in iver. Causes include
hepatitis B and C or large amounts of alcohol
consumption. Other diseases that can lead to cirrhosis
is a blockage of the bile ducts.
 Pathophysiology

Esophageal varices occurs when blood flow to the heart is

blocked. Your stream will look the other way is to veins in the
esophagus, stomach or rectal smaller and more easily broken.
Not imbangnya between the pressure of blood flow to the ability
of the blood vessels resulting in enlargement of the veins
(varicose veins).
Complication
Compilation esofaghus primary varicose veins are bleeding. Varicose veins are usually
susceptible esofaghus rebleeding occurred, especially in the first 48 hours. The possibility
of re-bleeding was also increased in patients with old age, liver or kidney failure and in
alcohol.
Complication esofaghus varicose veins are:
1. Hypovolemic shock
2. Encephalopathy
3. The infection, such as pneumonia aspiration
 Signs And Symptoms

The signs and the symptoms of bleeding esophageal

varices among others (students working guide books
STIK muhammadiyah pontianak):
1. Shock
2. Dizzy
3. Very thirsty
4. Vomiting blood
5. Tarry black stool
6. Urination becomes a bit
Management

Bleeding in esophageal varices should be addressed immediately,

otherwise death can occur. Things can be done to overcome the
bleeding, among others:
1. Ligation of varicose veins
2. Endoscopic injection therapy
3. Drugs – drugs
4. The balloon tamponade
5. Shortcuts intrahepatic portosystemic transjugularis.
Phatway

Attached
Nursing Care

Assessment

Assessment in patients with esophageal varices, including assessment of

history, physical examination and diagnostic assessment In the assessment of
the history, the main complaints in patients with esophageal varices varies
according to the clinical manifestations of loss resulting from esophageal
varices that affect organ systems.
Health history assessment undertaken to explore peremasalahan in
patients with esophageal varices.
On physical examination, the nurse started with an examination of the
general situation and the level of zerkesadaran, especially if there is a history-
melena massive hematemesis. TTV is an important inspection checks that
should be done at the time of the first discovery.
Examination of esophageal varices is focused on:
1. Inspection
Patients usually pale , jaundice, cyanosis due to decreased
oxygen saturation. Increased respiratory rate and respiratory
effort
2. Auscultation
Increased intestinal peristalsis
3. Percussion
Tap abdominal pain
4. Palpation
Hipokondrium region abdominal tenderness or below the right
and left ribs (Azer, 2009). Obtained enlarged parotid glands
(obtained in patients with alcoholism and malnutrition), enlarged
spleen (splenomegaly).
 Nursing Diagnosis
1. Deficit fluid volume associated with acute blood loss,
2. Damage to gas exchange associated with decreased oxygen
transport capacity and factors of risk of aspiration,
3. High risk of infection associated with intravenous stream,
Intervention

1. Monitor the volume of fluid each hour

2. Measure urine output per hour
3. Monitor S02 using oximetry or ABGs
4. Monitor breath sounds and onary symptoms
5. Use O2 supplement according to instruction
6. Monitor body temperature
7. Monitor for abdominal distension
8. Please note the behavior hint agitated example, easily aroused,
lack of eye contact, behavior against or attacking
9. Determine the patient's perception of the cause of bleeding
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