Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing II > Appendectomy/Cholecystectomy > Flashcards

Appendectomy/Cholecystectomy Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

Two major types of gallstones

A

pigment & cholesterol stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pigment stones

A

bilirubin salt, calcium bilirubinate & associated with bacteria in the bile. Can only be removed surgically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cholesterol Stones

A

more common. contain calcium salts & bile pigments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cholecystitis

A

inflammation of the gallbladder. Can be acute or chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does Acute Cholecystits develop?

A

Usually in association with cholelithiasis (gallstones) & high fat meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cholelithiasis

A

formation of gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptoms of Acute cholecystitis

A

Severe pain radiating from RUQ abdomen to midline & posterior scapular region described as “colicky”, N/V, low grade fever, possible jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens if a gallstone obstructs the cystic duct?

A

gallbladder becomes distended, inflamed & eventually infected (acute cholecystits)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Biliary colic

A

RUQ pain due to obstruction of a bile duct by a gallstone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Key sign for Cholecystitis

A

Patient is restless for 30min-6hrs after eating a meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cholecystitis makes stool what color & why?

A

white because gallbladder cant secrete any bile. Bile makes stool brown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What will urine look like with cholecystitis and why?

A

Urine may be dark & foamy b/c bilirubin increases which causes kidneys to try & filture out the bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A patient with cholecystitis will have an __________ WBC count

A

Incresed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cholecystiits medical objectives

A

supportive and dietary management to reduce the incidence of acute episodes of gallbladder pain & to remove the cause of cholecystitis by pharmacologic therapy, endoscopic procedures or surgical interventions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ursodiol (URSO)

A

a bile acid that dissolves gallstones and decreases biliary cholesterol formation. Used to treat asymptomatic cholecystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Who is at risk for cholecystitis?

A

3 F’s: Female, FAT, Forties. Chances increases with age, increased with pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why does cholecystitis increase with pregnancy?

A

because baby can smush gallbladder (that’s what Marty said) online says its because when youre pregnant you produce lots of estrogen which produces cholesterol (hence cholesterol stones)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Symptoms of chronic cholecystitis

A

not as severe as acute, more vague. Long-term intolerance of fatty foods, vague gastric symptoms, increased flatulence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cholecystitis diagnostics

A

Cholangiogram (Radiography of the bile ducts), endoscopic, IV, transhepatic, operative, oral cholecystograpy, CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cholecystitis surgical management

A

Laparoscopy cholecystectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cholecystectomy

A

removal of gallbladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Laparoscopic cholecystectomy

A

removal of the gallbladder through a small incision thru the umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

advantages of laparoscopic cholecystectomy

A 
Decreased:
 surgical risks,
 length of hospital stays, 
recovery periods & 
postoperative pain
Patient does not experience paralytic ileus that occurs with open abdominal surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How many incisions for a Laparoscopic cholecystectomy ?

A

4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How many incisions for a Laparoscopic Appendectomy?

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Preferred treatment for acute cholecystitis?

A

Early Laparoscopic cholecystectomy (within 24-48 hrs of symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

paralytic ileus

A

paralyzed intestines. Not able to pass stool or gas. happens often with abdominal surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

If a patient has paralytic ileus why don’t you want to give them a laxative?

A

Because stool will just build up and could bust appendix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Steps in Laparoscopic cholecystectomy

A
  1. ) Anesthesia is administered
  2. ) A small incision is made thru the abdominal wall at the umbilicus.
  3. )Abdominal wall is filled with carbon dioxide
  4. )The fiberoptic scope is inserted thru umbilicus
  5. ) other instruments make small incisions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why is abdominal wall filled with carbon dioxide during a laparoscopic cholecystectomy?

A

to assist in inserting the laparoscope & to aid in visualizing the abdominal structures

31
Q

Discharge instructions for a patient that had a laparoscopic cholecystectomy

A

written and verbal instructions about managing postoperative pain & reporting s/s of intra-abdominal complications

32
Q

Common s/s AFTER a laparoscopic cholecystectomy

A

pain or discomfort in right shoulder due to gas used to inflate abdominal area, may be drowsy afterward

33
Q

Abnormal s/s a patient that has had a laparoscopic cholecystectomy should report when home

A

redness, tenderness, swelling, heat, or drainage around incision site. Loss of appetite, vomiting, pain, distention of abdomen and temp elevation

34
Q

When should a patient who has had a laparoscopic cholecystectomy shower or take a bath?

A

after 1 or 2 days

35
Q

When should a patient who has had a laparoscopic cholecystectomy drive a car?

A

after 3 or 4 days

36
Q

How should a patient who has had a laparoscopic cholecystectomy care for wound?

A

check puncture site daily, wash with mild soap and water, allow special adhesive strips on site to fall of. DO NOT peel them off.

37
Q

Lithotripsy

A

sound waves that break up gallstones

38
Q

Appendicitis is most common in what age groups

A

10-30

39
Q

Where is the appendix located?

A

RLQ (usually) attached to the cecum just below the ileocecal valve

40
Q

Function of appendix

A

regularly fills with food & empties into cecum.

41
Q

Average length of appendix

A

3-6 inches

42
Q

peritonitis

A

inflamation of the serous membrane that lines the abdominal cavity

43
Q

what causes peritonitis

A

Rupture/perforation of appendix

44
Q

Appendicitis is most common in countries with…

A

diet low in fiber & high in refined carbs

45
Q

Key sign of appendicitis

A

Pain that moves from umbilicus to RLQ

46
Q

McBurney’s point

A

rebound pain. (when you push down on abdomin and pain starts when you lift off)

47
Q

where could the appendix be located if not in the RLQ?

A

lumbar region, pelvis, by kidney,

48
Q

Rovsing’s sign?

A

pain is felt when reverse side is palpated

49
Q

Fecalith

A

harden mass of stool

50
Q

pathophysiology of appendicitis

A

inflamation occurs –> decrease in blood supply
–>infection –>fluid secretion –> increase in pressure & once it exceeds venous pressure then blood flow is restricted –> further infection with more swelling –>gangrene from hypoxia or reputure can occur in 24-36 hrs

51
Q

obstruction of appendix can be caused by..

A

kinking, occlusion, adhesions, fecalith, tumor, intestinal worms, foreign material, viral infections causing enlarged lymphoid follicles

52
Q

What happens to abdomen once appendix is ruptured/perforated?

A

abdominal distention, abdomen may become ridgid, pain may become more diffused or it may subside b/c of a decrease in pressure

53
Q

MANTRELS score

A

Migration of pain, Anorexia, N/V,Tenderness, Rebound pain, Elevated temp, Leukocytosis, Shift to the left

54
Q

what MANTRELS signs are worth 2 points?

A

Tenderness * Leukocytosis. All others are 1 point

55
Q

simple appendicitis

A

appendix is inflamed & intact

56
Q

Gangrenous appendicitis

A

appendix has area of tissue necrosis & microscopic perforations present

57
Q

Perforated appendix

A

evidence of gross perforation & contamination of the peritoneal cavity

58
Q

what kind of anesthesia is used for a appendectomy?

A

general or spinal

59
Q

What sugical prodecures are prefored in the treatment of appendicitis with perforation

A

Laparotomy or laparoscopy. Lapaproscopy has a quicker recovery period

60
Q

Why cant you give a laxative or emea to a patient with appendicitis?

A

Because they have pain which doesnt allow them to poop. Giving a laxitive will just make it worse. They will have an increase in pressure and it may cause the appendix to burst

61
Q

When can you give a laxative to a patient with appendicitis?

A

AFTER surgery. It helps the patient decrease staining

62
Q

What may form due to perforation of the appendix

A

abscess

63
Q

What will the surgen do to help with an abscess

A

before surgery they will be put on antibiotics & during surgery, a drain will be placed in the abscess

64
Q

Heel-jar test

A

stand on tiptoe & suddenly drop both heels to the floor =RLQ pain=+ sign

65
Q

Hop Test

A

hop on one foot = RLQ pain = + sign

66
Q

what other tests can you do for appendicitis?

A

Cough test * if patient is too ill to stand, tap heel while pt is supine & fully extended=RLQ pain =+ sign

67
Q

lliopsoas muscle test

A

lie on left sign while right hip & legs are passively extended - a retroperitoneal appendix will have contact with muscle & elicit RLQ pain

68
Q

Obturator muscle test

A

lie supine with right hip flexed & passively rotated inward =+ sign

69
Q

Cutaneus hyperesthesia test

A

gently lifts fold of skin between thumb & index fingers without pinching at a series of points on abdomen, moving from UQ to LQ esp over McBurney’s point= + sign

70
Q

5-6 points on MANTRELS score

A

possible appendicitis

71
Q

7-8 points on MANTRELS score

A

probable appendicitis

72
Q

9-10 points on MANTRELS score

A

very probable

73
Q

If ithere is a possibility of peritonitis after surgery, what will the surgeon do?

A

A drain will be left in place at the area of the incision.

Nursing II (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions