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A patient presents to the emergency department and reports frequent small light-colored stools and fever. On examination, the nurse notes jaundice of the skin and sclera and a white blood cell (WBC) count of 15,000 /μL.
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An ultrasound examination indicates the patient has a dilated common bile duct with gallstones. What is the priority nursing intervention for this patient?
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concept of nursing 1
Cholelithiasis/Cholecystitis
| Question | Answer |
|---|---|
| A patient presents to the emergency department and reports frequent small light-colored stools and fever. On examination, the nurse notes jaundice of the skin and sclera and a white blood cell (WBC) count of 15,000 /μL. | -- |
| An ultrasound examination indicates the patient has a dilated common bile duct with gallstones. What is the priority nursing intervention for this patient? | Prepare the patient for an endoscopic retrograde cholangiopancreatography (ERCP) |
| During assessment of a patient for suspected cholelithiasis with biliary colic, a positive response to which question posed by the nurse would support the diagnosis? | “Do you have pain after consuming a high-fat meal?” |
| A 55-year-old obese African American woman has been admitted for a cholecystectomy to treat cholecystitis. The patient asks the nurse what factors might have predisposed her to cholecystitis. Which factors would the nurse mention? | -Female -Overweight -over the age of 40 |
| What would be the best collaborative care intervention for a patient admitted for treatment of an acute episode of cholecystitis who reports dry skin and severe itching? | Administer cholestyramine |
| A female patient scheduled for a laparoscopic cholecystectomy tells the nurse she is frightened because she has heard from others that the abdominal distention and pain after the surgery are severe. | -- |
| Which care team recommendation will best help alleviate distention? | “We will help you walk in the hall to decrease distention.” |
| A patient who is not a candidate for surgery is admitted to the hospital with acute cholecystitis and severe nausea and vomiting. Which collaborative care intervention will help maintain fluid and electrolyte balances? | Start an intravenous infusion of lactated Ringer’s solution |
| The nurse is preparing to administer an injection to a patient being treated for obstructive choledocholithiasis. The patient has been having severe episodes of nausea and vomiting and has a temperature of 100.2° F and bleeding gums. | -- |
| Which actions taken by the nurse will reduce potential complications from the injection? | -Apply gentle pressure to the injection site -Choose a 23-gauge needle to administer the medication |
| A patient who has undergone laparoscopic cholecystectomy asks the nurse about getting up and taking a shower. Which response by the nurse would be appropriate? | “It is best to do a bedside bath because you want to keep the dressing dry” |
| Which statement made by the student nurse when caring for a patient who has had an open cholecystectomy requires correction? | “I will teach the patient to resume normal activities in 2 weeks.” |
| Which nursing interventions will be most effective to alleviate nausea and vomiting by decreasing gallbladder stimulation in a patient with cholecystitis? | -Insert a nasogastric tube -Establish NPO (nothing by mouth) status for the patient |
Created by:
Lightnning54
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