Medical Surgical Esophageal varices #2

Question

A client with advanced cirrhosis of the liver has been informed they have esophageal varices. Which dietary items should the nurse teach the client to avoid since they have esophageal varices?

Answers

  1. Beef stew and crackers
    • Rationale:

      This answer is correct because the crackers are crunchy and potentially sharp, which can irritate and puncture the swollen, bulging varices. This can cause profuse bleeding, which can be life threatening. Interventions to stop bleeding include endoscopic band ligation or balloon tamponade procedures.

  2. Potato soup and a sandwich on white bread
    • Rationale:

      This answer is not correct because potato soup and a sandwich on white bread is a soft food and poses less risk to the bulging, swollen esophageal varices, compared to beef stew and crackers. Foods that are rougher and crunchy can potentially irritate and cause varices to rupture and bleed profusely. Therefore, the client should be taught to eat soft foods.

  3. Baked chicken and mashed potatoes
    • Rationale:

      This answer is not correct because baked chicken and mashed potatoes are soft foods and pose less risk to the bulging, swollen esophageal varices, compared to beef stew and crackers. Foods that are rougher and crunchy can potentially irritate and cause varices to rupture and bleed profusely. Therefore, the client should be taught to eat soft foods.

  4. Broiled fish and green beans
    • Rationale:

      This answer is not correct because broiled fish and green beans are soft foods and pose less risk to the bulging, swollen esophageal varices, compared to beef stew and crackers. Foods that are rougher and crunchy can potentially irritate and cause varices to rupture and bleed profusely. Therefore, the client should be taught to eat soft foods.

Overview

Clients with esophageal varices should be taught to avoid crunchy, hard foods since there is a risk of the food damaging the varices and causing profuse bleeding.

Explanation

Learning Outcomes

Esophageal varices are swollen, bulging veins located in the lower esophagus. This occurs as the result of increased blood pressure in the portal vein. The hypertension in the portal vein is associated with liver damage related to cirrhosis of the liver. The varices can be easily damaged, then rupture, and bleed. Therefore, the client should be taught to eat soft foods. Foods that are rougher and crunchy can potentially irritate and cause varices to rupture and bleed profusely. Interventions and treatments used to prevent bleeding include use of beta blockers to reduce pressure in the portal vein and endoscopic band ligation, which applies pressure to high risk varices to the varices so that it can not bleed. If the client is bleeding from ruptured varices, this can be life threatening. Balloon tamponade can be performed to apply pressure to the varices by blowing up a balloon to apply pressure directly on the bleeding varices.

Test Taking Tip

Remember to focus studies on prevention because it is so much better to prevent problems than to try to fix problems.

Video Rationale