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NURS 301 - Exam 3 > GI Alterations - Cholecystitis / Cholelithiasis / Appendicitis > Flashcards

GI Alterations - Cholecystitis / Cholelithiasis / Appendicitis Flashcards

1
Q

What is the function of the gallbladder?

A

Storage of bile

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2
Q

______ is the most common disorder of the biliary system

A

Cholelithiasis

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3
Q

What is cholelithiasis?

A

Stones in the gallbladder

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4
Q

Where can gallbladder stones be lodged? (2)

A
  • Neck
  • Cystic duct
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5
Q

What is cholecystitis?

A

Inflammation of the gallbladder

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6
Q

What are the risk factors of cholelithiasis / cholecystitis? (5)

A
  • Women > 40 years old
  • Post-menopausal women on estrogen therapy
  • Sedentary lifestyle
  • Genetics
  • Obesity
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7
Q

Describe the development of cholelithiasis

A

Precipitation of cholesterol, bile salts, and calcium

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8
Q

______ usually form in the gallbladder from the solid constituents of bile

A

Calculi (gallstones)

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9
Q

What conditions are considered risk factors of cholelithiasis? (2)

A
  • Infection
  • Decreased cholesterol metabolism
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10
Q

Cholecystitis is associated with obstruction caused by ______

A

Gallstones / biliary sludge

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11
Q

What is acalculous cholecystitis?

A

Inflammation with the absence of gallstones

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12
Q

What conditions are considered risk factors of acalculous cholecystitis? (3)

A
  • Prolonged immobility / fasting
  • Prolonged TPN
  • Diabetes
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13
Q

What are the manifestations of cholecystitis? (3)

A
  • Empyema
  • Pain in right upper abdomen
  • Pain radiating to mid-sternum / right shoulder
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14
Q

What is empyema?

A

Gallbladder filled with pus

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15
Q

What are the manifestations of cholelithiasis? (6)

A
  • Fever
  • Jaundice
  • Biliary colic
  • Dark urine / stool
  • Palpable abdominal mass
  • Feeling of fullness
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16
Q

What is biliary colic?

A

Severe pain / vomiting several hours after a heavy meal

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17
Q

What causes jaundice in cholelithiasis?

A

Blockage of common bile duct

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18
Q

What causes dark urine / stool in cholelithiasis?

A

Excretion of bile pigment

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19
Q

Obstruction of bile interferes with absorption of which vitamins?

A
  • A
  • D
  • E
  • K
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20
Q

What diagnostic studies are used for cholelithiasis / cholecystitis? (2)

A
  • Ultrasound
  • ERCP
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21
Q

What laboratory findings indicate cholelithiasis / cholecystitis diagnosis? (3)

A
  • Elevated WBC
  • Elevated bilirubin
  • Elevated AST / ALT
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22
Q

Treatment of gallstones depends on …

A

The stage of the disease

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23
Q

What type of medication is used for cholelithiasis?

A

Bile acids (cholesterol solvents)

24
Q

What is the primary treatment used for cholelithiasis?

A

Laparoscopic cholecystectomy

25
Q

What are the complications associated with surgical treatment of cholelithiasis / cholecystitis (3)

A
  • Bleeding
  • GI symptoms
  • Referred pain to shoulder
26
Q

______ is the most common cause of acute surgical abdomen / emergency abdominal surgery

A

Appendicitis

27
Q

What is appendicitis?

A

Inflammation / edema of the appendix

28
Q

What are the possible causes of appendicitis? (4)

A
  • Kinked appendix
  • Fecalith
  • Tumor
  • Lymphoid hyperplasia
29
Q

What is a fecalith?

A

Hardened mass of stool

30
Q

What eventually happens to the inflamed appendix?

A

Fills with pus

31
Q

What occurs once the appendix had been obstructed with pus? (3)

A
  • Ischemia
  • Bacterial overgrowth
  • Gangrene
32
Q

What are the manifestations of appendicitis? (6)

A
  • Low grade fever
  • Rebound tenderness
  • Pain at McBurney’s point
  • Rovsing’s sign
  • Psoas sign
  • Obturator sign
33
Q

Where is McBurney’s point?

A

Between the umbilicus and the anterior superior iliac spine

34
Q

What is rebound tenderness?

A

Intensification of pain when pressure is relieved

35
Q

Describe Rovsing’s sign

A

Pain at RLQ upon palpation of LLQ

36
Q

Describe Psoas sign

A

Pain upon slow extension of right thigh - while laying on left side

37
Q

Describe Obturator sign

A

Pain upon passive internal rotation of right thigh - while laying supine

38
Q

Manifestations of appendicitis depend on …

A

Position of the appendix

39
Q

If the appendix curls behind the cecum, pain can be felt …

A

In the lumbar region

40
Q

If the tip of the appendix is resting against the rectum, pain can be felt …

A

Upon defecation

41
Q

What does diffuse pain indicate?

A

Appendix may have ruptured

42
Q

What diagnostic studies are used for appendicitis? (2)

A
  • CBC
  • Pregnancy test - r/o ectopic pregnancy
43
Q

What laboratory findings indicate appendicitis diagnosis? (2)

A
  • Elevated WBC
  • Elevated neutrophils
44
Q

What is the most serious complication associated with appendicitis?

A

Perforation - can lead to peritonitis

45
Q

When do manifestations of perforation occur?

A

24 hours after onset of pain

46
Q

What are the manifestations of perforation? (3)

A
  • Fever > 100
  • Toxic appearance
  • Supine / motionless - due to extreme pain
47
Q

What other complications are associated with appendicitis? (4)

A
  • Ileus
  • Peritonitis
  • Pelvis abscess
  • Subphrenic abscess
48
Q

Describe the medical management of appendicitis (3)

A
  • Appendectomy
  • Antibiotics
  • IV fluids
49
Q

______ are at a higher risk of appendicitis recurrence

A

Males

50
Q

Describe the process of an appendectomy (2)

A
  • General / spinal anesthesia
  • Abdominal incision / laparoscopic
51
Q

What occurs if an abscess is found during an appendectomy? (3)

A
  • Drain abscess
  • IV antibiotics
  • Perform surgery when infection subsides
52
Q

What position should the patient be in to decrease pain post-op appendectomy?

A

High flowers - reduces pressure on incision / organs

53
Q

What type of medication is given post-op appendectomy?

A

Opioids (usually morphine)

54
Q

When can food be given post-op appendectomy?

A

When bowel sounds return

55
Q

Describe the post-op education associated with an appendectomy (3)

A
  • Incision care
  • No heavy lifting for 2 - 4 weeks
  • Schedule follow-up appointment for suture removal

NURS 301 - Exam 3 (5 decks)

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