Posts Tagged ‘esophageal varices’

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Tortoise and Hare: Top 15 AJN Blog Posts for Past Quarter

June 22, 2012

By Jacob Molyneux, AJN senior editor/blog editor

Dance Floor, via Flickr

We haven’t done as many posts as usual for the past few months. Various contributors are on the lam, vacationing, singing arias, earning PhDs, watching “Game of Thrones” episodes over and over and the like. So be it. 

But here is a list of the most popular posts over the past three months, in case you missed any of these at the time. Of necessity, since this is a blog, some are more ephemeral in their subject matter and relevance than others.

One or two, like “Do Male Nurses Face Reverse Sexism?”, are several years old but still hit the mark. Some were quick studies, grabbed all their readers in a matter of a few days and then tapered off quickly, while others came on slowly like the tortoise, steadily accumulating readers, asserting their charm via random Google searches.

Feel free to let us know what topics you’d like to see covered in the future. We can’t promise we can deliver, but it’s good to get a variety of perspectives. A greater clinical focus? More on policy? More on the nuts and bolts of nursing subspecialties? More personal narratives from nurses or patients? More posts related to recent published research? More polls? Trivial gossip about celebrities? To repeat: Let us know! And enjoy the early summer weekend.

“The Case of Amanda Trujillo”

“New Nurses Face Reality Shock in Hospital Settings – So What Else is New?

“‘How Can You Bear to Be a Nurse?’ – Nurses Week Begins”

“The ‘Inexhaustible Well’: Notes from a Trauma Nurse on Mortality”

“E-Cigarettes: Positive Smoking Substitute or a New Problem Replacing the Old?”

“Grief: The Proposed DSM-5 Gets It Wrong”

“iPad Apps, the Future of Nursing, More: Notes from the Nurse Execs Meeting in Boston”

“Gym Class, or Physical Education?”

“Emergency—Bleeding Esophageal Varices: What Nurses Need to Know”

“Parting Thoughts: 10 Lessons Learned from Florence Nightingale’s Life”

“Is the Florence Nightingale Pledge in Need of a Makeover?”

“Confused About the Charge Nurse Role? You’re Not Alone”

“What to Do If the Nursing Board Takes Action Against You: A Lawyer and Former RN Advises”

“Do Male Nurses Face Reverse Sexism?”

“To the Nursing Class of ’12 (and ’84, and ’96, and ’01)”

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Emergency—Bleeding Esophageal Varices: What Nurses Need to Know

February 1, 2010

By Sylvia Foley, AJN senior editor

esophageal varices

This month’s  CE feature opens with a patient with alcoholic cirrhosis who suddenly vomits large amounts of blood. She’s experiencing variceal hemorrhage from esophageal varices, an often deadly complication of alcoholic liver disease, as author Melissa M. Smith explains. Esophageal varices occur in roughly half of all people with alcoholic cirrhosis; about one-third of these will experience variceal hemorrhage.

Smith describes the etiology of esophageal varices, then discusses the risk factors for variceal hemorrhage, noting that risk for initial hemorrhage increases with:

  • larger variceal size
  • presence of red spots or wales on the varices
  • more severe portal hypertension
  • more severe cirrhosis, with or without ascites

And the above factors as well as the following increase risk for recurrent hemorrhage:

  • severity of initial bleed
  • age over 60 years
  • bacterial infection
  • renal failure
  • active alcoholism

Smith discusses emergent treatment and outlines further treatment options, which include endoscopic variceal ligation, endoscopic injection sclerotherapy, balloon tamponade, and transjugular intrahepatic portosystemic shunt (TIPS) placement. The patient case vividly illustrates what can happen when bleeds recur.

Have you cared for patients with variceal hemorrhage? We invite you to share your experiences with us in the comments.

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