Gall Bladder Disorders (Online Lecture) Flashcards
cholecystitis
inflammation or infection of gallbladder (acute or chronic)
cholelithiasis
stone formation
cholecystectomy
surgical removal of gallbladder
icterus
jaundice
ERCP
endoscopic
retrograde
choleagnio
photography
what is the most common cause of gallbladder disease
stones
s/s of inflammation of gallbladder/pancreas/liver
inflamation
edema
strictures
risk factors for gall stone formation
female
family hx
obesity
type 1 DM
aging
hyperlipidemia
cirrhosis
estrogen containing meds
pregnancy
gall stones obstruct flow of the bile in the gall bladder and starts a chemical reaction and autolysis and edema occurs, blood feels in gallbladder become compressed causing
decrease blood supply
gangrene
rupture
90% of the time inflammation of gallbladder is caused by gall stones, what can cause the other 10%
trauma
shock
dehydration
burns
torsion
multiple transfusions
s/s of acute cholecystitis
pain
tenderness
rigidity of RUQ
- radiates to midsternal area and right shoulder
N/V
heart burn
elevated wbc
general maliase
temp elevation
symptoms of acute cholecystitis can be triggered by what type of food
fattu
what do we rule out before we think to diagnosis GI related issues
cardiac
acute cholecystitis
- bowel sounds
may not hear them
acute cholecystitis
- Murphys sign
palpate RUQ pain when holding breath
acute cholecystitis
- rebound tenderness
release pressure = pain
acute cholecystitis
- urine color
dark because releasing bile pigments
acute cholecystitis
- pain management
morhpine
acute cholecystitis
- elderly
atypical
- septic shock
- high fever
- chills
- low back pain
- tenderness
acute cholecystitis
- CBC
elevated and shift to left
acute cholecystitis
- serum bilirubin
would be elevated
acute cholecystitis
- electrolytes
may be abnormal due to vomiting
acute cholecystitis
- alkaline phosphatase
normally elevated
acute cholecystitis
- serum amylase and lipase
rule out pancreatitis
acute cholecystitis
- ultrasound
quick
cheap
low risk
able to see tumor
acute cholecystitis
- medical interventions
- decrease inflammation
IV antibioitcs
rest
acute cholecystitis
- medical management
- NPO
low fat diet after recovery
acute cholecystitis
- medical management
- pain
opioid therapy
acute cholecystitis
- NG
suction to help N/V
acute cholecystitis
- surgical therapy
laparoscopic cholecystectomy
- gold standard
- fast recovery
- less severe post op pain
post of laparoscopic cholecystectomy
- other person
need someone home for 24-48 hours
post of laparoscopic cholecystectomy
- teaching of complications (call or go to er)
rigid abdomen
N/V
anorexia
pain
abdominal distention
fever
post of laparoscopic cholecystectomy
- teaching shoulder pain
very common
do not call doctor
treatment is increase activity and heating pad
secondary to gas used and gas helps surgeon visualize the organs
open cholecystectomy
- pain control
need this to do breathing and mobility
open cholecystectomy
prevent respiratory complications
can’t cough and deep breath due to midline incision
so we need pain control
open cholecystectomy
- gradual reintroduction of food and fluids
when they have bowel sounds and are passing gas
open cholecystectomy
- due to pain, deep breathing, and lack of mobility what are they at risk for
DVT and PE
