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30 Cards in this Set
- Front
- Back
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Cholecysititis
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inflammation of gallbladder, usually associated with stones in gallbladder
Acute (most common) or chronic |
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Cholelithiasis
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stones present in the gallbladder cause inflammation and obstruction
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Cholangitis
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inflammation of common bile duct
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Jaundice
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yellow discoloring of skin and mucous membrance
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Icterus
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yellow discoloration of sclera
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Puritis
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Itching associated with elevated serum bilirubins/Above 2.5mg/dl
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Biliary colic
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Extreme pain when stone impacts in common bile duct
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What 2 organs share the common bile duct?
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gallbladder and pancreas
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Cause of jaundice?
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back up of bile in biliary tract or obstruction causes concentration of biliruben in the blood increases jaundice occurs.
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Acute vs chronic cholecystitis?
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Acute caused by gallstones/obstruction
Chronic caused by edema decreased blood flow |
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Causes of chronic cholecystitis?
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decreased blood flow d/t
tumors opioid use immobility dieting/fasting |
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s/s of chronic cholecystitis
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jaundice, icterus, puritis, elevated bilirubin, clay-colored stools, urine becomes dark and frothy
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Nonsurgical intervention for Cholecystitis/ Choleithiasis?
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Pain relief!- no morphine, usually dilauded
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Diet for acute Cholecystitis/ Choleithiasis
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NPO, NG Tube
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Diet for chronic Cholecystitis/ Choleithiasis
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low-fat, low-volume
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2 types of gallstones?
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Cholesterol (Fat) or Pigment (alcohol) stones
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What causes gallstones?
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Abnormal metabolism of cholesterol and bile salts
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s/s gallstones?
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Biliary colic: stone in CBD, tachycardia, pallor, diaphoresis.
Jaundice,icterus |
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Txs for Choleithiasis
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Surgical removal
Drugs to dissolve stones (can take 1-2 yrs) Extracorporeal shock wave Lithotripsy Percutaneous transhepatic biliary catheter insertion: |
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Extracorporeal shock wave Lithotripsy
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Shatters stones through shock wave.(3 or fewer stones)
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Extracorporeal shock wave Lithotripsy not indicated for pts...
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No indicated for clients with pacemakers, defibs, or pregnancy
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Percutaneous transhepatic biliary catheter insertion
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Floroscopic guidance. For non-sugrical canidates
Will have T-Tube frequently |
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Postcholecystectomy syndrome
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Occasionally seen. Residual or recurring calculi, inflammation or stricture of CBD
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What is the most common way to remove a stone?
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papillotome
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**Post op care for cholecystectomy pt?
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Low Fowler’s position- take pain/stress off belly
May have NG tube- not with laparoscopic NPO until bowel sounds return, then a soft, low-fat, high-carbohydrate diet postoperatively Care of biliary drainage system Administer analgesics as ordered and medicate to promote/permit ambulation and activities, including deep breathing. Turn, and encourage coughing and deep breathing, splinting to reduce pain. Ambulation |
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**Pt teaching post cholecystectomy
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Medications for pain
Diet: at discharge, maintain a nutritious diet and avoid excess fat. Fat restriction is usually lifted in 4-6 weeks. Instruct in wound care, dressing changes, care of T-tube. Activity- ambulate Instruct patient and family to report signs of gastrointestinal complications, changes in color of stool or urine, fever, unrelieved or increased pain, nausea, vomiting, and redness/edema/signs of infection at incision site. |
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Do we irrigate, aspirate, or clamp t-tubes?
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NO!
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What is impartant to remember about skin care and t-tubes?
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drainage (bile) can digest pts skin, need to be very careful about protecting the skin
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Can we flush NG tubes port cholecystectomy?
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Yes, because there are no surgical incisions in/on stomach
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The priority nursing care for a pt with a T-Tube is to avoid...
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raising the drainage system above the level of the gallbladder?
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