NCLEX-PN® ExaminationPhysiological AdaptationHard
A client is admitted to the emergency department with a suspected ruptured esophageal varices. The nurse understands that which medication is most likely to be prescribed to reduce portal pressure and control bleeding?
- ALactulose
- BOctreotide
- CSpironolactone
- DPantoprazole
Show answer & explanationAnswer & explanation
Correct answer: B. Octreotide
Octreotide is a somatostatin analog that causes splanchnic vasoconstriction, thereby reducing portal blood flow and pressure, which is crucial for controlling bleeding from esophageal varices. Pantoprazole is for acid suppression, lactulose for ammonia reduction, and spironolactone for ascites management, none of which directly address acute variceal bleeding.
Why the other options are wrong
- A. Lactulose is used to reduce ammonia levels in hepatic encephalopathy, not for acute variceal bleeding.
- C. Spironolactone is a potassium-sparing diuretic used to manage ascites and edema in liver disease, not for acute variceal bleeding.
- D. Pantoprazole (proton pump inhibitor) reduces gastric acid but does not directly reduce portal pressure or variceal bleeding.
Esophageal Varices Bleeding
Bleeding from esophageal varices is a life-threatening complication of portal hypertension, requiring rapid intervention to reduce portal pressure and control hemorrhage.
- Octreotide is the first-line pharmacologic treatment for acute variceal bleeding.
- It works by decreasing splanchnic blood flow.
- Endoscopic interventions (banding, sclerotherapy) are also crucial.
Memory trick: Octreotide Obstructs Outflow.