gallbladder disorders Flashcards
cholelithiasis
stones in the gallbladder
cause of gallbladder stones
UNKNOWN
risk factors for gallbladder stones (cholelithiasis)
gender
age
estrogen
lifestyle (obese + sedentary)
diet
family hx
function of bile
help digest lipids and transport waste products
components of bile
bilirubin, cholesterol, bile salts, water, protein, and calcium
where does bile come from?
produced in liver and store in gallbladder
eating a meal that contains fat signals gallbladder to release bile then flows into duodenum
patho of cholelithiasis
bile stasis –> super-saturation with cholesterol –> precipitation
stones remain in gallbladder and migrate through ducts - can cause pain, obstruction, cholecystitis
clinical manifestations of cholelithiasis
-sometimes silent
*severity dependent on: movement of stones, obstruction
-biliary colic
biliary colic means
steady, severe pain ~1 hr
RUQ, may radiate to R shoulder
occurs:
S/S:
obstructed bile flow: clinical manifestations
-jaundice
-dark amber urine that foams when shaken
-clay colored stools
-steatorrhea
-pruritis
-intolerance to fatty foods
-bleeding
obstructed bile flow: jaundice
bile cannot flow into duodenum
obstructed bile flow: dark amber urine that foams when shaken
soluble bilirubin in urine
obstructed bile flow: clay colored stools
bilirubin does not reach small intestine to be converted into urobilinogen
obstructed bile flow: steatorrhea
no bile salts in duodenum - prevents fat digestion
obstructed bile flow: pruritis
deposit of bile salts into skin tissue
obstructed bile flow: intolerance to fatty foods
no bile in small intestine to help with fat digestion
obstructed bile flow: bleeding tendencies
decreased absorption of vitamin K
cause of cholecystitis
most common: obstruction from gallstones or biliary sludge
-prolonged immobility/fasting
-bacterial infection
-parenteral nutrition
-diabetes mellitus
patho of cholecystitis
obstruction –> inflammation
gallbladder becomes: edematous, hyperemic, distended
over time: scarring and decreased functioning
clinical manifestations of cholecystitis
similar to cholelithiasis
systemic: fever, N/V, restlessness, diaphoresis
lab values of cholecystitis
bilirubin, liver enzymes (ALT&AST), WBC, amylase
peritoneal involvement in cholecystitis
drugs to give for gallbladder problems
-analgesis (ketorolac)
-antiemetics
-anticholinergics
-bile acids
analgesics are given for
pain control
antiemetics are given for
N/V
anticholinergics are given for
decrease gallbladder secretion and stop smooth muscle spasms
bile acids are given for
dissolve stones
**rarely used
