Exam 2- Gall Bladder Flashcards
Cholecystitis
Inflammation of the gall bladder
Chloelithiasis
Stone formation
Cholecystectomy
Surgical removal of gall bladder
Icterus
Jaundice, common s/s
ERCP
Endoscopic retrograde choleangiopancreatography
Cholangitis
Inflammation of the bile ducts
Choledocholithiasis
Common bile duct stone
Etiology of GB disease
Gallstones
Result of gall stones
Edema and stricture
Gall stones are made up of…
2/3 cholesterol and 1/3 pigment
Tumors can be caused by…
Gall stones
GB Disease risk factors
- Female gender
- Family history
- Obesity
- Type 1 DM
- Aging
- Hyperlipidemia
- Cirrhosis
- Estrogen containing medications
- Pregnancy
Is GB disease usually symptomatic or asymptomatic?
Asymptomatic
Acute inflammation of the GB
Acute cholecystitis
Reasons and causes for cholecystitis
Trauma, shock, dehydration, burns, torsion, obstructions, multiple transfusions, alterations in fluids and electrolytes or visceral blood flow
This is more of a problem with increasing age
Acute cholecystitis
Acute cholecystitis clinical manifestations
- Pain
- Tenderness
- Rigidity of RUQ
- Nausea/vomiting
- Heart burn
- Flatulence
- Fever, chills
- Elevated WBC
- Dark urine
- Clay colored stool
Acute cholecystitis pain may radiate to…
Right scapula, shoulder, or mid-sternum
Acute cholecystitis diagnostics
- Lab work
- Ultrasound
- Abdominal X-Ray
- HIDA Scan
- Endoscopic retrograde cholangiopancreatography (ERCP)
Acute cholecystitis lab work
- CBC
- Serum Bilirubin
- Electrolytes
- Liver Function test
- Alkaline phosphatase
- Serum Amylase and lipase
What does HIDA scan look at?
Looks at filling and emptying of the GB
Acute cholecystitis medical management
- Decrease inflammation
- NPO
- Pain management
- Dissolution therapy
Acute cholecystitis therapy: NPO
Low fat diet after recovery
Acute cholecystitis pain management
Opioid therapy (Morphine)
For acute cholecystitis, what do we use to decrease inflammation?
- IV antibiotics
- Rest
Gall bladder disease gold standard surgical therapy
Laparoscopic Cholecystectomy
Gall Bladder disease nursing care post-op laparoscopic cholecystectomy
- Need someone at home with them for the first 24-48 hours
- Teaching about S/S complications
- Often able to resume employment/baseline activity within 1-3 weeks
For GB disease, what do we teach about S/S complications?
- Nausea/vomiting
- Anorexia
- Pain
- Abdominal distention
- Fever
- Shoulder pain
Post-op nursing care for an open cholecystectomy
- Pain control
- Prevent respiratory complications
- T-tube of JP care (instructions for home)
- NPO (oral care)
- Gradual reintroduction of food/fluids
What doesn’t get treatment if pain is not severe?
Cholelithiasis
Treatment for cholelithiasis
Lithotripsy
& Insertion of biliary catheter
- T-tube
- Exploration of CBD
