NURS365 - Hepatobiliary I & II (Exam 2)
What is the patho for cholecystitis - inflammation of the gallbladder, usually caused by gallstones obstructing the
cystic duct
- leads to bile buildup, inflammation, and possible infection
What are S/S for cholecystitis - RUQ pain
- fever
- chills
- Nausea/vomiting
- jaundice
- tender RUQ
- indigestion
- fat intolerance
- diaphoresis
- referred pain to the shoulder/scapula
What is the diagnosis for cholecystitis - Ultrasound
- ERCP
- PTC
- labs (incrwased WBC, bilirubin, liver enzymes)
What are interprofessional care/management for Medications:
cholecystitis - antibiotics
- NG tube for severe
- opioids for pain
- anticholinergics to reduce GI
spasms Surgery:
- laparoscopic cholecystectomy
- Open cholecystectomy if severe disease
- T-tube drainage if bile duct obstruction
, What are interventions for cholecystitis - Pain control
- monitor for infection
- monitor vital signs
- maintain NG tube if present
- post-op care after cholecystectomy
- replace fluid and electrolyte losses
- skin care with biliary drainage tubes
What is the patho for cholelithiasis - gallstones form in the gallbladder (usually from cholesterol)
- they can block bile flow
- bile is needed to digest fat → when blocked = problems
What are the S/S for cholelithiasis - RUQ pain
- pain after high-fat meals
- pain occurs 3-6 hours after eating
- nausea and vomiting
- diaphoresis
- tachycardia
- referred pain to shoulder or scapula
- jaundice if obstruction occurs
- dark urine
- clay-colored stools
- fat intolerance
what are the risk factors for cholelithiasis - Female
- Age > 40
- Obesity
- Multiparity
- Estrogen therapy
- Sedentary lifestyle
- Family history
What are the diagnosis for cholelithiasis Imaging:
- Ultrasound
- ERCP
- Percutaneous Transhepatic Cholangiography (PTC)
Labs:
- increase WBC
- increased bilirubin
- increased liver enzymes
- increased amylase
What is the interprofessional care/management for - oral dissolution therapy (urosodiol, chenodiol)
cholelithiasis - ERCP with spincterotomy to remove stones
- lithotripsy (shock wave therapy)
- surgery if needed
What is the interventions for cholelithiasis - pain control
- monitor liver function
- monitor for obstruction
- low-fat diet
- pain education about gallstone symptoms
What is the patho for cholecystitis - inflammation of the gallbladder, usually caused by gallstones obstructing the
cystic duct
- leads to bile buildup, inflammation, and possible infection
What are S/S for cholecystitis - RUQ pain
- fever
- chills
- Nausea/vomiting
- jaundice
- tender RUQ
- indigestion
- fat intolerance
- diaphoresis
- referred pain to the shoulder/scapula
What is the diagnosis for cholecystitis - Ultrasound
- ERCP
- PTC
- labs (incrwased WBC, bilirubin, liver enzymes)
What are interprofessional care/management for Medications:
cholecystitis - antibiotics
- NG tube for severe
- opioids for pain
- anticholinergics to reduce GI
spasms Surgery:
- laparoscopic cholecystectomy
- Open cholecystectomy if severe disease
- T-tube drainage if bile duct obstruction
, What are interventions for cholecystitis - Pain control
- monitor for infection
- monitor vital signs
- maintain NG tube if present
- post-op care after cholecystectomy
- replace fluid and electrolyte losses
- skin care with biliary drainage tubes
What is the patho for cholelithiasis - gallstones form in the gallbladder (usually from cholesterol)
- they can block bile flow
- bile is needed to digest fat → when blocked = problems
What are the S/S for cholelithiasis - RUQ pain
- pain after high-fat meals
- pain occurs 3-6 hours after eating
- nausea and vomiting
- diaphoresis
- tachycardia
- referred pain to shoulder or scapula
- jaundice if obstruction occurs
- dark urine
- clay-colored stools
- fat intolerance
what are the risk factors for cholelithiasis - Female
- Age > 40
- Obesity
- Multiparity
- Estrogen therapy
- Sedentary lifestyle
- Family history
What are the diagnosis for cholelithiasis Imaging:
- Ultrasound
- ERCP
- Percutaneous Transhepatic Cholangiography (PTC)
Labs:
- increase WBC
- increased bilirubin
- increased liver enzymes
- increased amylase
What is the interprofessional care/management for - oral dissolution therapy (urosodiol, chenodiol)
cholelithiasis - ERCP with spincterotomy to remove stones
- lithotripsy (shock wave therapy)
- surgery if needed
What is the interventions for cholelithiasis - pain control
- monitor liver function
- monitor for obstruction
- low-fat diet
- pain education about gallstone symptoms
