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AHIII - chapter 54
| Question | Answer |
|---|---|
| Cholecystitis | Inflammation of the gallbladder; mostly due to stones (calculi; cholelithiasis); s/s: jaundice & icterus, clay-colored stools, steatorrhea, pruritis, 4 F’s (female, forty, fertile, & fluffy), & pain |
| Gallbladder & bile | Gallbladder stores bile; bile breaks down fat (produced by the liver, so patient won’t be jaundiced from gallstones) |
| Nursing problems of cholecystitis | 1) Pain 2) Weight loss due to pain & nausea |
| Surgical management of cholecystitis | Lap chole (*make sure to include the possibility of it becoming an open procedure in the consent form*) |
| Risk factors for cholecystitis | Pg. 1178 |
| Biliary colic | Produced by obstruction of the cystic duct of the gallbladder or movement of one or more gallstones (*monitor for shock*) |
| Cholecystitis labs | Elevated WBC, AST, & LDH |
| Nonsurgical management of cholecystitis | Opioids (may cause Oddi spasm), Ketorolac (potent NSAID), or percutaneous transhepatic biliary catheter (drain for bile) |
| Cholecystectomy | Surgical removal of the gallbladder |
| Pain of gallbladder vs. pancreatitis | Gallbladder: right upper quadrant, radiating up to right shoulder/back; pancreatitis: left upper quadrant |
| Pancreatitis | Inflammation -> enzymes can’t get out -> leaking out to pancreatic duct & becomes active -> autodisgestion: eating at itself -> necrotic -> hemorrhage |
| Pancreatitis interventions | PCA pump for pain, NPO to keep GI system quiet to prevent activating the enzymes, & IV fluids or TPN in the meantime |
| Pancreatitis S/S | Pain, jaundice, hyperglycemia (release of glucagon because of decrease in insulin), pleural effusions, multiorgan failure can result,& *increased amylase & lipase; hypocalcemia |
| Imaging assessment of pancreatitis | Abdominal ultrasound |
| Nursing problems of pancreatitis | Pain & weight loss |
| Nonsurgical management of pancreatitis | IV fluids, pain control, & fetal position |
| Endoscopic Retrograde Cholangioancreatography (ERCP) | Deeper than an EGD; done to remove stones |
| Chronic pancreatitis | Progressive, destructive disease of the pancreas that has remissions & exacerbations (“flare-ups”); alcoholism is the primary risk factor; intervention: pancreatic enzyme replacement therapy (PERT), surgery is not a primary intervention |
| Pancreatic cancer | Poor prognosis; usually late diagnosis because of vague s/s; interventions: for large tumors, surgeons may perform a whipple procedure; nonsurgical - chemo & radiation |
| Risks factors associated with pancreatic cancer | DM, chronic pancreatitis, cirrhosis, high intake of red meat, long-term exposure to chemicals, obesity, older age, male gender, cigarette smoking, family history, or genetic mutations |
| Key features of pancreatic cancer | Pain radiating to back, jaundice, weight loss, glucose intolerance, & new onset DM |
Created by:
tatianalopez03
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