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Acute Rehab > case study 4 - Cholecystectomy > Flashcards

case study 4 - Cholecystectomy Flashcards

1
Q

what is a Cholecystectomy

A

surgery to remove the gallbladder.

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2
Q

where in the body is the gallbladder

A

a pear-shaped organ that sits just below the liver on the upper right side of the abdomen.

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3
Q

what does the gallbladder do

A

collects and stores a digestive fluid made in the liver called bile.

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4
Q

what are the two types of surgery to remove the gallbladder

A
  • keyhole (laparoscopic)
  • open surgery (laparotomy)
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5
Q

where will the incision be from the cholecystectomy?

A

incision in your abdomen below your ribs on your right side.

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6
Q

what is bile

A

a fluid that is made and released by the liver and stored in the gallbladder. Bile helps with digestion. It breaks down fats into fatty acids

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7
Q

what is a bladder stone

A

hard lumps of minerals that can form inside the bladder when it’s not completely empty of urine.

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8
Q

symptoms of bladder stone

A
  • bladder pain
  • lower abdominal pain
  • dark coloured urine
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9
Q

what is cellulitus

A

deep bacterial infection of the skin

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10
Q

how does cellulitus present

A
  • redness
  • swelling
  • pain in area
  • restricted ROM
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11
Q

what is the semi-recumbent position.

A

30-45 degree tilt of upper torso to help prevent ventilator acquired pneumonia
- open airways

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12
Q

what will lower lobe haziness present as on x-ray and why may she have this?

A
  • haziness (white shadow across lower lobes)
  • due to surgery she is liekly to have swelling in the lower abdominal region, in turn affecting lungs expansion
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13
Q

what is respiratory alkanosis fully compensated

A
  • ph fine
  • co2 fine
  • bicarbonate low
  • hyperventilation
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14
Q

What is patient controlled Anesthesia?

A

a type of pain management that lets you decide when you will get a dose of pain medicine.

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15
Q

How could you treat cellulitis in right lower limb

A
  • keep leg elevated using cushion to reduce swelling and can alleviate pain
  • drink plenty of fluids
  • do foot pump exercises to maintain rom in ankle
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16
Q

what is cellulitis caused by

A
  • usually by a bacterial infection
17
Q

what is a ventilator

A
  • machine that mechanically helps you breath
  • can be invasive (intubated) or non-invasive (CPAP)
18
Q

how would you assess secretion retention in lower lobes of lungs?

A
  • auscultation (hear fine crackles lower lobes or diminished sounds)
  • would be beneficial for chest x-ray
  • risk of atelectasis
  • vocal fremitus
  • cough strength
19
Q

how would you treat lower lobe secretion retention?

A
  • due to surgery being yesterday, not acceptable to use postural drainage/chest percussion
  • Teach ACBT techniques (thoracic expansion, diaphragmatic, FET)
  • supported cough
20
Q

what evidence supports the use of ACBT for secretion retention

A
  • Zisi et al 2022
  • explain aim, method, findings, conclusion
  • ACBT is effective in increasing the expectorated sputum volume, in reducing viscoelasticity of the secretion.
  • Amiel will therefore be able to clear secretions
21
Q

How would you assess decreased exercise tolerance

A
  • dysnoea scale
  • respiratory rate (likely to be increased)
  • outcome measure 30 second chair sit and stand - for her age 70 should be able to do 13. (use borg scale before and after or dyspneoa (breathlessness) scale)
22
Q

How would you assess decreased chest expansion

A
  • observe respiratory rate (likely to be increased)
  • borg scale
  • palpate accessory muscles looking for hypertrophy
23
Q

How would you treat decreased chest expansion

A
  • ACBT (thoracic expansion, FET and diaphragmatic)
  • dyspneoa relieving positions
  • do marching on the spot for 30 seconds, then perform the ACBT (supported by evidence from Bailey et al 2007)
24
Q

what evidence supports the use of ACBT for chest expasnion

A

incentive spirometer, Zisi et al

25
Q

what is haziness in chest x-ray

A

fluid collection between the lung and the chest wall appearing whiter than the lungs and making the sharp lung borders on the film hazier
- likely to be pleural effusion

26
Q

what is pleural effusion

A

buildup of fluid between the layers of tissue that line the lungs and chest cavity.

27
Q

what is cholecistis

A

inflammation caused by gallbladder stones

28
Q

what is cholelithiasis

A

hardened depositis of digestive fluid formed in gallbladder (stones)

29
Q

what is consolidation in chest

A

The consolidated parts of your lung look white, or opaque, on a chest X-ray.
- likely to be build of of fluid in small air sacs, such as pus, water, blood leading to pneumonia etc.

30
Q

what are some post operative abdominal complications

A
  • shock
  • wound infection
  • DVT
  • pulmonary embolism
  • urinary retention
  • atelectasis
31
Q
A

Acute Rehab (7 decks)

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