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15 Cards in this Set
- Front
- Back
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two major disorders of the biliary tract
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Cholelithasis-stones in gall bladder
Cholecystitis- inflammation of the gallbladder |
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one of the most common surgical procedures for disorders of the biliary tract
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Cholecystectomy
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Highest incidence of cholelithasis
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(fair, fat, 40), women myltipara, over 40, obesity, white
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etiology of cholelithasis
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unknown
alteration in cholesterol, bile salts, calcium stasis of bile |
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pathophysiology of cholecystitis
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inflammation, during acute attack gallbladder is edematous and hyperemic, may be distended with bile or puss
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cholecystitis clinical manifestations
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indegestion to severe pain with fever and jaundice
pain (RUQ) may refer to shoulder and scapula, n/v, diaphoresis, leukocytosis, abdominal rigidity, very guarding, can palpate gallbladder, steatorrhea, ot able to tolerate fat |
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cholelithasis diagnostic studies
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US- best diagnostic
ERCP-visualize remove increased liver enzymes-amylase,AST, ALT Increased WBC Direct and indirect bilirubin elevated because of obstruction urinary bilirubinlevated with obstruction |
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___ will be elevated if pancreas is involved in choleithasis.
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Serum amylase
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treatment for cholecystitis
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pain management
antibiotics maintain fluid and electrolytes anticholinergics |
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nonsurgical treatment of cholelithasis
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ERCP- placement of stents, removal of stones, sphinterotomy
Mechanical lithotripsy (crushes stones but can create pancreatitis) |
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medications used for non surgical treatment of cholelithasis
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cholesterol solvents-MTBE is instilled into gallbladder with catheter
dissolution medication-Actigall Shock wave lithotripsy(ESWL) |
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surgical treatment for cholelithasis
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laparoscopis cholecystectomy
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Cholegastrostomyis duct between stomach and gall bladder, what is patient teaching
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diet
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post op lap chole
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monitor for bleeding, VS, common post op pain-shoulder, place client on left side
liquids first day advance as tolerated monitor for bowel sounds low fat diet monitor for DVT increase activity, deep breathe, may discharge same day if doing well |
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nursing interventions for surgical chole
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turn cough deep breathe, make sure no draining puss, check bowel sounds to advane diet as ordered by physician, avoid heavy lifting
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