Medical Surgical Hiatal Hernia #3

Question

The client with a hiatal hernia questions the nurse as to the cause of the condition. Which reply from the nurse is best?

Answers

  1. “A hiatal hernia is a result of weakening muscles of the diaphragm and is provoked by abdominal pressure.”
    • Rationale:

      This answer is correct because when the abdomen puts pressure on muscles of the diaphragm that are weak, it pushes the stomach through the diaphragm and into the thorax. This results in the herniation. Abdominal pressure factors include pregnancy, obesity, ascites, or heavy lifting.

  2. “A hiatal hernia is caused by the backflow of stomach contents into the throat due to inadequate sphincter function.”
    • Rationale:

      This answer is not correct because this is the definition of gastrointestinal reflux. This backflow of stomach contents causes dyspepsia and regurgitation from an inadequate esophageal sphincter.

  3. “A hiatal hernia is caused by rapid emptying of the stomach contents into the small intestines from a gastric resection.”
    • Rationale:

      This answer is not correct because the rapid emptying described is called dumping syndrome. Dumping syndrome occurs usually after a gastric resection due to part of the stomach being resected.

  4. “A hiatal hernia is due to poor absorption of nutrients which causes inflammation of the bowels.”
    • Rationale:

      This answer is not correct because poor absorption of nutrients is due to bowel inflammation. This condition is called ulcerative colitis. When bowels are inflamed, nutrients are not as easily absorbed by the intestines.

Overview

A hiatal hernia is when a part of the stomach breaches through the diaphragm and into the thorax. This is caused by abdominal pressure on already weakened diaphragm muscles.

Explanation

Learning Outcomes

A hiatal hernia is when part of the stomach breaches through the diaphragm and into the thorax. This is caused by abdominal pressure from factors such as pregnancy, obesity, ascites, or heavy lifting. The symptoms of GERD are similar to the symptoms of hiatal hernia. GERD is caused from backflow of stomach contents into the esophagus due to an inadequate esophageal sphincter. Symptoms of regurgitation and the feeling of fullness are associated with GERD, as with hiatal hernia. Rapid emptying of stomach contents into the small intestines is a result of a gastric resection. This is called dumping syndrome. Since part of the stomach is gone, the food moves more quickly into the small intestines to be eliminated. Ulcerative colitis is inflamed bowels that causes poor absorption of nutrients.

Test Taking Tip

Have knowledge as to the potential cause of hiatal hernia.

Video Rationale