Exam 2- Gall Bladder

Question 1

Cholecystitis

Answer 1

Inflammation of the gall bladder

Question 2

Chloelithiasis

Answer 2

Stone formation

Question 3

Cholecystectomy

Answer 3

Surgical removal of gall bladder

Question 4

Icterus

Answer 4

Jaundice, common s/s

Question 5

ERCP

Answer 5

Endoscopic retrograde choleangiopancreatography

Question 6

Cholangitis

Answer 6

Inflammation of the bile ducts

Question 7

Choledocholithiasis

Answer 7

Common bile duct stone

Question 8

Etiology of GB disease

Answer 8

Gallstones

Question 9

Result of gall stones

Answer 9

Edema and stricture

Question 10

Gall stones are made up of…

Answer 10

2/3 cholesterol and 1/3 pigment

Question 11

Tumors can be caused by…

Answer 11

Gall stones

Question 12

GB Disease risk factors

Answer 12

• Female gender
• Family history
• Obesity
• Type 1 DM
• Aging
• Hyperlipidemia
• Cirrhosis
• Estrogen containing medications
• Pregnancy

Question 13

Is GB disease usually symptomatic or asymptomatic?

Answer 13

Asymptomatic

Question 14

Acute inflammation of the GB

Answer 14

Acute cholecystitis

Question 15

Reasons and causes for cholecystitis

Answer 15

Trauma, shock, dehydration, burns, torsion, obstructions, multiple transfusions, alterations in fluids and electrolytes or visceral blood flow

Question 16

This is more of a problem with increasing age

Answer 16

Acute cholecystitis

Question 17

Acute cholecystitis clinical manifestations

Answer 17

• Pain
• Tenderness
• Rigidity of RUQ
• Nausea/vomiting
• Heart burn
• Flatulence
• Fever, chills
• Elevated WBC
• Dark urine
• Clay colored stool

Question 18

Acute cholecystitis pain may radiate to…

Answer 18

Right scapula, shoulder, or mid-sternum

Question 19

Acute cholecystitis diagnostics

Answer 19

• Lab work
• Ultrasound
• Abdominal X-Ray
• HIDA Scan
• Endoscopic retrograde cholangiopancreatography (ERCP)

Question 20

Acute cholecystitis lab work

Answer 20

• CBC
• Serum Bilirubin
• Electrolytes
• Liver Function test
• Alkaline phosphatase
• Serum Amylase and lipase

Question 21

What does HIDA scan look at?

Answer 21

Looks at filling and emptying of the GB

Question 22

Acute cholecystitis medical management

Answer 22

• Decrease inflammation
• NPO
• Pain management
• Dissolution therapy

Question 23

Acute cholecystitis therapy: NPO

Answer 23

Low fat diet after recovery

Question 24

Acute cholecystitis pain management

Answer 24

Opioid therapy (Morphine)

Question 25

For acute cholecystitis, what do we use to decrease inflammation?

Answer 25

- IV antibiotics - Rest

Question 26

Gall bladder disease gold standard surgical therapy

Answer 26

Laparoscopic Cholecystectomy

Question 27

Gall Bladder disease nursing care post-op laparoscopic cholecystectomy

Answer 27

- Need someone at home with them for the first 24-48 hours - Teaching about S/S complications - Often able to resume employment/baseline activity within 1-3 weeks

Question 28

For GB disease, what do we teach about S/S complications?

Answer 28

- Nausea/vomiting - Anorexia - Pain - Abdominal distention - Fever - Shoulder pain

Question 29

Post-op nursing care for an open cholecystectomy

Answer 29

- Pain control - Prevent respiratory complications - T-tube of JP care (instructions for home) - NPO (oral care) - Gradual reintroduction of food/fluids

Question 30

What doesn't get treatment if pain is not severe?

Answer 30

Cholelithiasis

Question 31

Treatment for cholelithiasis

Answer 31

Lithotripsy & Insertion of biliary catheter - T-tube - Exploration of CBD