NURS 2589 Chapter Notes - Chapter 45: Diffuse Esophageal Spasm, Hiatus Hernia, Calcium Channel Blocker
15 Mar 2019
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Document Summary
Normal in amplitude but uncoordinated, move quickly, or occur at various places in the esophagus at once. First-line therapy includes calcium channel blockers and nitrates. Soft, frequent feedings and soft diet are usually recommended to decrease esophageal pressure and irritation that lead to spasm. Opening in the diaphragm through which the esophagus passes become enlarged and part of the upper stomach moves into the lower part of the thorax. Sliding (type i)- upper stomach and gastroesophageal junction are displaced upward and slide in and out of the thorax. Paraesophageal (type 2-4) intra- abdominal viscera like colon, spleen, or small bowel evidencing displacement into chest along with the stomach. Frequent small feedings that pass easily through the esophagus. Don"t recline an hour after eating to prevent reflux or movement of hernia. Elevate head of bed on 4-8 inch block to prevent hernia from sliding upward.
