Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
medsurg exam 3
cholelithiasis vs cholesystitis
| Question | Answer |
|---|---|
| bile production | 600-800 ml/day, produced by the liver |
| bile facilitates | fat digestion, absorption of fat and fat soluble vitamins (A, D, E, K) and cholesterol |
| bile emulsifies | fat for absorption |
| gallbladder anatomy | just below the liver, 3-4" long storage unit |
| gallbladder stores | 20-50 ml of bile |
| function of gallbladder | store and concentrate bile |
| cholelithiasis | the formation of stones within the GB or biliary ducts (gallstones) |
| how many major types of stones | 2 major types |
| gallstones | problem arise if stone blocks a duct |
| which ducts can be blocked in gallstones | cystic duct, common bile duct |
| common risk factors of cholelithiasis | Age Native American, Northern European Family history Obesity Rapid weight loss (bariatric surgery) Female>male Pregnancy, use of oral contraceptives Diet |
| why is pregnancy a risk in cholelithiasis | the hormones increase cholesterol production |
| diet that can cause cholelithiasis | low fiber, high calories |
| cholelithiasis symptoms | acute, severe, sudden pain in epigastric region that can radiate to back and shoulder and can last 30min-5hrs n,v |
| complications of cholelithiasis | perforation, necrosis |
| cholesystitis | inflammation of the gallbladder |
| cholecystitis relationship to cholelithiasis | 90% of cases caused by cholelithiasis |
| symptoms of cholecystitis | fever, nausea, vomiting, and intense pain when taking deep breaths |
| bilirubuin | breakdown of RBC |
| biliary obstruction | pts will appear jaundiced when total bilirubin exceeds > 3.0 mg/dL |
| Elevated direct/conjugated biliary obstruction | liver is doing its job but not getting through the bile duct |
| Elevated indirect or unconjugated bilirubin biliary obstruction | due to liver disease |
| urine and stool appearance in biliary obstruction | Urine will appear dark Stools clay colored/steatorrhea |
| what else is common in biliary obstruction | vitamin deficiencies and itching |
| diagnostic testing | Ultrasonography- quick, no ionizing radiation |
| types of dx testing | Gallbladder scan – HIDA Serum bilirubin CBC |
| Gallbladder scan – HIDA is a test that | puts a radioactive tracer to go through the biliary track |
| CBC reveals | elevated WBC |
| management of cholelithiasis | Cholecystectomy Medication |
| Cholecystectomy | removal of gallbladder |
| types of Cholecystectomy | open and laparoscopic |
| medical management of cholecystitis | reduce pain NPO -> low fat diet Semi fowler position Pharmacological therapies |
| reduce pain using | Morphine/opioids Antiemetics Antibiotics |
| Pharmacological therapies | Cholesterol stone dissolution with ursodiol (Actigall) or chenodiol to prevent/dissolve gallstones |
| invasive procedures for cholecystitis | ERCP Cholecystectomy |
| ERCP | E = endoscopic R = retrograde C = cholangio P = pancreatography |
| ERCP allows for | direct visualization of the common duct and can be done via an endoscope to retrieve stones & place stents |
| Laparoscopic Cholecystectomy | treatment of choice, usually 24 hr admit return to work in 1 week |
| Abdominal (Open) Cholecystectomy | 4-6 week recovery greater incidence of ileus & complications |
| post op management | Pain relief Abdominal assessment Pulmonary toilet-CDB, incentive spirometry, AMBULATE Incisional care Antibiotic Diet |
| what to assess during abdominal assessment | ileus, bile leak |
| Incisional care | T-tube (choledochostomy) - if a lot of inflammation |
| diet education | avoid excessive fat! |
| antibiotics for | the infection |
Created by:
leh195