NCLEX Review & Nursing School

HIATAL HERNIA

– is also called diaghragmatic hernia.
– protrusion of the stomach through the esophageal hiatus of the diaphragm

• THERE ARE TWO TYPES:

1. SLIDING HERNIA- ALMOST LIKE GERD (MAJOR CONCERN- REFLUX AND IT’S COMPLICATIONS)
2. ROLLING HERNIA- THE FUNDUS ROLLS THROUGH THE ESOPHAGIAL HIATUS AND INTO THE THORAX.

Assessment:
Barium swallow study w/ fluoroscopy

– There is a herniation in the portion of the stomach, protruding towards the thoracic cavity.
Assessment/ Symptoms:
Symptoms are very similar to GERD:

• DYSPHAGIA (DIFFICULTY SWALLOWING)
• ODYNOPHAGIA (PAINFUL SWALLOWING)
• REGURGITATION OF FOODS
• HEARTBURN (DYSPEPSIA)

There are two types:

• SLIDING OR ROLLING HERNIA
• PARAESOPHAGEAL HERNIA

Diagnosis:

• BARIUM SWALLOW X- RAY.
• DIRECT VISUALIZATION BY ENDOSCOPY.

Management/ Treatments:

• MANAGEMENT AND TREATMENTS ARE THE SAME AS GERD.

Treatment:
Elevate the head of bed
Give antacids
Administer H2 Blockers
Administe Proton Pump Inhibitor
Encourage  smaller frequent meals.

Common Drugs to help control symptoms of Hiatal Hernia:

Rantidine (Zantac)  – Histamine Blocker –  decreases gastric acid secretions.

Magnesium Hydroxide (Maalox) – Antacid – decreases the heartburn.

Lansoprazole (Prevacid) – Protein Pump Inhibitor – decreases gastric acid secretions.