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8 Cards in this Set

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Cholelithiasis

Gallstones – 90% cholesterol gallstones

Cholecystitis

Inflammation of Gallbladder( usually caused by obstruction d/t gallstones)

4 F's Risk Factors For Gallbladder disordes

fat, female, fertile, forty, (flatulence, family hx)

Manifestations

-indigestion, mild to severe pain RUQ, R shoulder, scapula, fever, jaundice, N,V


-Cholelithiasis severity depends on the stone


-dark amber urine foamy, clay coloured stool, pruritus, bleeding tendencies, steatorrhea (fat in feces),

Complications

-Cholangitis (inflammation of bile duct)


- rupture of bladder


-fistula (abnorm. passaway)


-bile peritonitis


-biliary cirrhosis

Diagnostic Studies

Ultrasonography/ ERCP (bile sample), Lab : visualize and detect stones



Collaborative Care

Conservative therapyCholecystitis - pain mgt, abx, maintenance of fld & electrolyte balance, NG, anticholinergic – decrease secretion and counteract smooth muscle spasms


Cholelithiasis – Biles acids – to dissolve stones, ERCP clears stones from 90%, extracorporeal shock wave therapy


Surgical therapy - laparoscopic cholecystectomy


Drug therapy – analgesics, anticholinergics (antispasmodics & relax smooth muscles), fat-soluble vitamins (A,D,E,K), bile salts (facilitate digestion & vitamin absorption)


Nutritional therapy – smaller, more frequent meals, with some fat at each meal to promote gallbladder emptying, low in saturated fats (butter), high in fibre & Ca+

Patient Teaching

Cholecystectomy: remove bandage on puncture site after surgery, notify surgeon of redness or severe abdominal pain, resume normal activities gradually, return within 1 wk if no complications, normal/low-fiet diet


-fat soluble supplement, avoid heavy lifting