NSG 123 Med Surg Exam 2: Cholelithiasis & Related
Conditions| Questions and Answers Latest Updated
2026/2027 (Graded A+)-Herzing
Med Surg Exam 2
Main Cause of Cholelithiasis:
Cholesterol stones account for most of the remaining 75% of cases of gallbladder disease in the
United States.
Symptoms of Cholelithiasis:
Nausea
Vomiting
Right upper quadrant abdominal pain or epigastric pain that radiates to the right shoulder
especially after meals when the gallbladder is stimulated to release bile.
Patient Teaching for Cholelithiasis:
The diet immediately after an episode is usually low-fat liquids. These can include powdered
supplements high in protein and carbohydrates stirred into skim milk.
Purpose of Medication in Cholelithiasis:
Purpose of Medications: reduces hepatic production of cholesterol.
Lowers the cholesterol content of bile, which in turn facilitates the gradual dissolution of
cholesterol gallstones.
Examples : Chenodiol (Chenodal, Chenix) is a naturally occurring bile acid .
Purpose of Adding Fat to Emulsion to TPN:
Fat emulsions (lipids) are usually given to clients receiving TPN to provide supplemental
kilocalories and prevent fatty acid
Fat emulsions can also control hyperglycemia during periods of stress.
Carbon Dioxide in Laparoscopic Cholecystectomy:
Carbon dioxide is used during the procedure
Explain to the patient that they might feel pain in the right shoulder or scapular area (from
migration of the carbon dioxide used to insufflate the abdominal cavity during the procedure).
,Laparoscopic Cholecystectomy 3 Things to do After:
Recommend a heating pad for 15 to 20 minutes hourly or
Encourage the client to ambulate frequently to reduce the bloating.
Manage nausea assess bowel sounds for further complications.
Preoperative Assessment for Open Cholecystectomy:
Priority assessment should focus on the client's respiratory status.
If a traditional surgical approach is planned, the high abdominal incision required during surgery
may interfere with full respiratory excursion.
The nurse notes a history of smoking, previous respiratory problems, shallow respirations, a
persistent or ineffective cough, and the presence of adventitious breath sounds.
CBC and BMP should also be assessed
4 Postoperative Complications of Cholecystostomy:
After these surgical procedures, the client is observed for indications of infection, leakage of bile
into the peritoneal cavity, and obstruction of bile drainage.
If bile is not draining properly, an obstruction is probably causing bile to be forced back into the
liver and bloodstream.
Because jaundice may result, the nurse should assess the color of the sclerae. Yellow-colored
sclerae or skin can indicate jaundice.
Clay-colored stool should be reported as this indicates a complication.
Discharge Teaching for Open Cholecystectomy:
Usually, only a small amount of serosanguineous fluid drains in the initial 24 hours after surgery;
afterward, the drain is removed.
The drain is typically maintained if there is excess oozing or bile leakage.
Empty the drainage bag attached at least every 8 hours and as needed, to prevent reflux back into
the bile duct.
Take showers not baths to prevent infection of the incision site.
What disease is characterized by possible malnourishment (anemic) and frequent
diarrhea?:
Crohn's disease
, The disease characterized by blood stools and left lower quadrant pain:
Ulcerative Colitis
What GI disease would be best diagnosed with colonoscopy?:
Ulcerative Colitis
What testing would you expect to see from a patient receiving parenteral nutrition?:
Blood Glucose
What time of day should Famotidine (pepcid) be administered?:
Bed time
What is an intragastric balloon used for?:
Non-invasive weight loss
The nurse needs to check Mg++ before administration of what drug?:
Magnesium hydroxide/aluminum hydrate MAALOX
Which weight loss drug requirres a fat soluble vitamin supplement?:
Orlistat (XENICAL)
What do you give to treat travelers diarrhea?:
Bismuth Salts-pepto bismol
This condition is characterized by perianal vascular congestion from straining to have a
bowel movement?:
Hemorrhoids
Conditions| Questions and Answers Latest Updated
2026/2027 (Graded A+)-Herzing
Med Surg Exam 2
Main Cause of Cholelithiasis:
Cholesterol stones account for most of the remaining 75% of cases of gallbladder disease in the
United States.
Symptoms of Cholelithiasis:
Nausea
Vomiting
Right upper quadrant abdominal pain or epigastric pain that radiates to the right shoulder
especially after meals when the gallbladder is stimulated to release bile.
Patient Teaching for Cholelithiasis:
The diet immediately after an episode is usually low-fat liquids. These can include powdered
supplements high in protein and carbohydrates stirred into skim milk.
Purpose of Medication in Cholelithiasis:
Purpose of Medications: reduces hepatic production of cholesterol.
Lowers the cholesterol content of bile, which in turn facilitates the gradual dissolution of
cholesterol gallstones.
Examples : Chenodiol (Chenodal, Chenix) is a naturally occurring bile acid .
Purpose of Adding Fat to Emulsion to TPN:
Fat emulsions (lipids) are usually given to clients receiving TPN to provide supplemental
kilocalories and prevent fatty acid
Fat emulsions can also control hyperglycemia during periods of stress.
Carbon Dioxide in Laparoscopic Cholecystectomy:
Carbon dioxide is used during the procedure
Explain to the patient that they might feel pain in the right shoulder or scapular area (from
migration of the carbon dioxide used to insufflate the abdominal cavity during the procedure).
,Laparoscopic Cholecystectomy 3 Things to do After:
Recommend a heating pad for 15 to 20 minutes hourly or
Encourage the client to ambulate frequently to reduce the bloating.
Manage nausea assess bowel sounds for further complications.
Preoperative Assessment for Open Cholecystectomy:
Priority assessment should focus on the client's respiratory status.
If a traditional surgical approach is planned, the high abdominal incision required during surgery
may interfere with full respiratory excursion.
The nurse notes a history of smoking, previous respiratory problems, shallow respirations, a
persistent or ineffective cough, and the presence of adventitious breath sounds.
CBC and BMP should also be assessed
4 Postoperative Complications of Cholecystostomy:
After these surgical procedures, the client is observed for indications of infection, leakage of bile
into the peritoneal cavity, and obstruction of bile drainage.
If bile is not draining properly, an obstruction is probably causing bile to be forced back into the
liver and bloodstream.
Because jaundice may result, the nurse should assess the color of the sclerae. Yellow-colored
sclerae or skin can indicate jaundice.
Clay-colored stool should be reported as this indicates a complication.
Discharge Teaching for Open Cholecystectomy:
Usually, only a small amount of serosanguineous fluid drains in the initial 24 hours after surgery;
afterward, the drain is removed.
The drain is typically maintained if there is excess oozing or bile leakage.
Empty the drainage bag attached at least every 8 hours and as needed, to prevent reflux back into
the bile duct.
Take showers not baths to prevent infection of the incision site.
What disease is characterized by possible malnourishment (anemic) and frequent
diarrhea?:
Crohn's disease
, The disease characterized by blood stools and left lower quadrant pain:
Ulcerative Colitis
What GI disease would be best diagnosed with colonoscopy?:
Ulcerative Colitis
What testing would you expect to see from a patient receiving parenteral nutrition?:
Blood Glucose
What time of day should Famotidine (pepcid) be administered?:
Bed time
What is an intragastric balloon used for?:
Non-invasive weight loss
The nurse needs to check Mg++ before administration of what drug?:
Magnesium hydroxide/aluminum hydrate MAALOX
Which weight loss drug requirres a fat soluble vitamin supplement?:
Orlistat (XENICAL)
What do you give to treat travelers diarrhea?:
Bismuth Salts-pepto bismol
This condition is characterized by perianal vascular congestion from straining to have a
bowel movement?:
Hemorrhoids
