Medical-Surgical Nursing
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| What is cholelithiasis? | Gallstones
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| What is cholecystitis? | Inflammation of the gallbladder
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| True or False: A person can have cholelithiasis without cholecystitis. | True
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| What drugs are associated with an increased risk of gallbladder disease? | Estrogen replacement therapy and oral contraceptives
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| Bile that is supersaturated with cholesterol
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| If the cystic duct is blocked, can bile flow into the duodenum? | Yes, through the common bile duct; however, bile can't escape the gallbladder
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| What is acalculous cholecystitis? | Cholecystitis in the absence of obstruction
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| What drugs are associated with acalculous cholecystitis? | Opioids
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| What is biliary colic? | Spasms in the gallbladder in response to a gallstone
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| What S/S are associated with biliary colic? | Tachycardia, diaphoresis, and prostration
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| Where does pain occur with cholecystitis and cholelithiasis? | In the RUQ, but can referred to the scapula
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| What is cholangitis? | Inflammation of the biliary ducts
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| A stone in the common bile duct
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| What is used to diagnose cholelithiasis? | Ultrasound
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| What is the normal serum amylase level? | 23-85 U/L
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| What are normal serum bilirubin levels? | 0.1-1.2 mg/dL
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| If serum amylase levels are elevated with gallbladder disease, what should you expect? | Pancreatic involvement
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| True or False: Liver enzymes are usually not elevated with gallbladder disease. | False; they usually are elevated.
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| What drugs are used to dissolve gallstones? | Bile acids (cholesterol solvents)
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| Why are gallstones usually not treated with drugs? | Because of the success of laparoscopic cholecystectomy.
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| What is the main complication of laparoscopic cholecystectomy? | Injury to the common bile duct
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| How soon after laparoscopic cholecystectomy can a patient resume normal activities? | 1 week
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| What are the fat soluble vitamins? | A, D, E, and K
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| Why are anticholinergics used with cholecystitis? | To decrease GI secretions and counteract smooth muscle spasms.
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| What drug is given to relieve pruritus associated with gallbladder disease? | Cholestyramine
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| How is Cholestyramine administered? | In powder form mixed with milk or juice.
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| What diet is best for patients with gallbladder disease? | Small, frequent meals with some fat; high in fiber and calcium
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| Why should rapid weight loss be avoided in patients with gallbladder disease? | It can promote gallstone formation
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| What should the patient eat the rest of the day after laparoscopic cholecystectomy? | Liquids only
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| When can a patient return to a normal diet after incisional cholecystectomy? | When bowel sounds return
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| True or False: Multiparity increases the risk for gallbladder disease. | True
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| What type of baths may relieve pruritus associated with gallbladder disease? | Baking soda or Alpha Keri
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| What are S/S of obstruction of the ducts by stones? | Clay-colored stools; dark, foamy urine; steatorrhea; fever; and leukocytosis
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| How can a patient be positioned to relieve post-op laparoscopic cholecystectomy pain? | In Sims' position (on left side with right knee flexed)
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| True or False: It is normal for a T-tube to drain 300-500 mL of thin, blood-tinged bile the first 24 hours post-op after an incisional cholecystectomy. | True
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| What does post-op nursing care for an incisional cholecystectomy focus on? | Adequate ventilation and prevention of respiratory complications
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| When can a patient shower after laparoscopic cholecystectomy? | When the bandages are removed the day after surgery
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