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NUR2125 > cholelithiasis + cholecystitis > Flashcards

cholelithiasis + cholecystitis Flashcards

1
Q

what is cholelithiasis

A

the presence of 1 or more gall stones in the gall bladder.

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2
Q

what is cholecystitis?

A

gall bladder inflammation and can be a complication of gall stones, sludge ( when bile stays in the gall bladder for too long) , or structural/ functional disorders.

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3
Q

what is chole?

A

bile or gall

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4
Q

what organ makes cholesterol/bile?

A

liver

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5
Q

what is cholecystectomy?

A

to remove the gall bladder

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6
Q

which is the function of gall bladder?

A

to store bile

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7
Q

early symptoms of cholecystitis

A

indigestion cause the bile stone stuck at the bile duct.
pain
tenderness in the upper right quadrant ( pain may refer to right shoulder and scapula)
nausea vomiting
restlessness
diaphoresis (sweating)

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8
Q

symptoms of progression to acute cholecystitis

A

severe pain,
fever
chills
jaundice
inflammation.

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9
Q

what to assess for cholecystitis ( physical examination)

A

pain - COLDSPA
leukocytosis ( elevated WBC) - infection
tachycardia
restlessness
fever
jaundice - affect the liver
changes in urine or stool appearance
abdominal rigidity.

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10
Q

symptom of chronic cholecystitis :
what happens if it keeps recurring?

A

if acute inflammation resolves but continues to recur, the gallbladder becomes fibrotic and contracted, does not concentrate bile or empty normally.

patients will report a history of fat intolerance, dyspepsia( indigestion) heartburn and flatulence.

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11
Q

possible diagnostic tests for cholecystitis

A

blood tests
gallbladder ultrasound
abdominal CT scan

Gallbladder
radionucleotide scan (HDA SCAN)

endoscopic retrograde cholangiopancreatography ( ERCP)

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12
Q

what types of blood test will be ordered for cholecystits

A

CBC
Liver function test
bilirubin
amylase end lipase

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13
Q

what enzymes are found in liver ?

A

AST- Aspartate Transaminase 0-35
GGT - Gamma-glutamyl transpeptidase 9-48
*ALT - Alanine Transaminase 0-35
ALP- Alkaline phosphotase 20-140

*ALT is more specific to the liver, it is found in the liver cells, it can be released into the blood stream when damaged - serum ALT is high.

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14
Q

where is GGT found?

A

concentrated in the liver, found in gall bladder, spleen, pancreas, kidneys

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15
Q

where are ALP made in a pregnant woman

A

liver and placenta

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16
Q

what are the functions of liver enzymes? ( AST ALT GGT ALP)

A

enzymes helps break down protein and have an important role in liver function and bone development.

17
Q

what does it indicate if the liver fxn test is high

A

underlying medical condition involving the liver, bones, gall bladder.

18
Q

what is a common cause of ALT elevation?

A

Nonalcoholic fatty liver disease (NAFLD) or alcoholic liver disease

19
Q

a possible cause of ALP elevation other than gall bladder related.

A

bone cancer metastasis

20
Q

what are the 2 main groups of serum protein?

what’ s the third one?

A

albumin and globulin ( 6-8.3)

fibrinogen

21
Q

what does albumin attract?

what does it do?

A

sodium

it helps to keep out adequate volume out of the intravascular space to maintain an adequate blood pressure.

22
Q

what is bilirubin

A

a waste product when old red blood cells are worn out and removed and recycled by the liver.

23
Q

what causes high bilirubin levels?

A

bilirubin cant make it to the intestine to be broken down and excreted, back up in the liver, causes circulating blood levels of bilirubin to rise.

24
Q

cholecystitis complications

A

gangrenous gall bladder, suphrenic abscess, pancreatitis, cholangitis, biliary cirrhosis, fistulas, and rupture of the gall bladder.

25
Q

what are the drugs for cholecystitis?

A

ceftriaxone and metronidazole

26
Q

what is ceftriaxone?

A

a beta lactam antibiotic, 3rd gen cephalosporin.
it inhibits bacterial cell wall synthesis- bactericidal and is broad spectrum.

Need to monitor for rash and diarrhea.

27
Q

what is metronidazole?>

A

it is a DNA synthesis inhibitor, in disrupts the DNA synthesis via oxidative stress.

fight against protozoans and anaerobes. monitor for headache, dizziness, stomach pain, nausea, metallic taste

28
Q

Abnormal lab values for cholecystitis

A

Leukocytosis
Elevated bilirubin and or without alkaline phosphate

29
Q

Complications of cholecystitis

A

Gangrenous gall bladder to sepsis

Rupture of gallbladder - peritonitis

Suphrenic abscess
Pancreatitis
Cholangitis
Billiary cirrhosis
Fistulas

NUR2125 (17 decks)

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