During assessment of a patient with obstructive jaundice, the nurse would expect to find:
Man ordinarily tolerates mechanical obstruction of the common bile duct fairly well. Death from obstructive jaundice in the first few weeks of its course is quite rare and is only occasionally observed. After a period varying from four to six months, however, patients suffering from occlusion of the common bile duct usually deteriorate rapidly and die. During the greater portion of this time, save for the loss of weight and accompanying loss of strength incident to the altered digestion and assimilation of the ingested food, the patient remains ordinarily wholly free from any threatening symptoms. Then suddenly the picture of a rapidly progressive intoxication is superimposed on the silent jaundice; ascites, coma and spontaneous hemorrhages may supervene, and death quickly follows. Show
Somewhat more than a year ago, a patient was admitted to the surgical service of the University Hospital with a profound icterus of more than three and one-half years' Cholecystitis is the acute or chronic inflammation of the gallbladder.
What is Cholecystitis?Several disorders affect the biliary system and interfere with normal drainage of bile into the duodenum.
ClassificationThere are two classifications of cholecystitis:
PathophysiologyCalculous and acalculous cholecystitis have different origins.
Statistics and IncidencesCholecystitis account for most patients requiring gallbladder surgery.
CausesThe causes of cholecystitis include:
Clinical ManifestationsCholecystitis causes a series of signs and symptoms:
ComplicationsCholecystitis can progress to gallbladder complications, such as:
Assessment and Diagnostic FindingsStudies used in the diagnosis of cholecystitis include:
Medical ManagementManagement may involve controlling the signs and symptoms and the inflammation of the gallbladder.
Pharmacologic TherapyThe following medications may be useful in patients with cholecystitis:
Surgical ManagementBecause cholecystitis frequently recurs, most people with the condition eventually require gallbladder removal.
Nursing ManagementManagement of cholecystitis include the following: Nursing Assessment
Nursing DiagnosisBased on the assessment data, the major nursing diagnosis for the patient may include:
Nursing Care Planning & GoalsMain Article: 4 Cholecystitis and Cholelithiasis Nursing Care Plans The major goals for the patient include:
Nursing InterventionsTreatment of cholecystitis depends on the severity of the condition and the presence or absence of complications.
EvaluationExpected patient outcomes are:
Discharge and Home Care GuidelinesThe focus of discharge instructions for patients with cholecystitis is education.
Documentation GuidelinesThe focus of documentation should include:
Practice Quiz: CholecystitisHere are some practice questions for this study guide. Please visit our nursing test bank page for more NCLEX practice questions. 1. The initial course of treatment for a patient with cholecystitis may include: A. Analgesics and
antibiotics 1. Answer: D. All of the above. Analgesics and antibiotics are primary medications for a patient with cholecystitis, and nasogastric suctioning is performed to prevent gastric sludge.
2. A patient with cholecystitis is limited to low-fat liquids only. As foods are added to the diet, the patient must know that the following should be avoided: A. Cooked fruits. 2. Answer: B. Eggs and cheese. Eggs and cheese are rich in cholesterol which is contraindicated in patients with cholecystitis.
3. Postoperative nursing observation includes assessing for: A. Indicators of infection. 3. Answer: D. All of the above. Assessing the indicators of infection, leakage of bile, and obstruction of bile drainage are all appropriate measures postoperatively.
4. Marie, a 51-year-old woman, is diagnosed with cholecystitis. Which diet, when selected by the client, indicates that the nurse’s teaching has been successful? A. 4-6 small meals of low-carbohydrate foods daily. 4. Answer: C. Low-fat, high-carbohydrate meals. For the client with cholecystitis, fat intake should be reduced.
5. Which clinical manifestation would the nurse expect a client diagnosed with acute cholecystitis to exhibit? A. Jaundice, dark urine, and steatorrhea 5. Answer: D. Nausea, vomiting, and anorexia Acute cholecystitis is an acute inflammation of the gallbladder commonly manifested by the following: anorexia, nausea, and vomiting.
See AlsoRelated posts:
[sc name=”Affiliate_MedicalSurgical”] What are the symptoms of obstructive jaundice?Yellowing of the skin and whites of the eyes, light-coloured stools and dark urine could be signs of obstructive jaundice – a condition where normal drainage of bile from the liver to the small intestines is blocked.
What happens in obstructive jaundice?What is obstructive jaundice? Obstructive jaundice is a condition in which there is blockage of the flow of bile out of the liver. This results in the redirection of excess bile and its byproducts into the blood, and bile excretion from the body is incomplete.
Which assessment findings are consistent with common bile duct obstruction?The following results would suggest a biliary obstruction: higher than usual levels of bilirubin. higher than usual levels of alkaline phosphatase. higher than usual levels of liver enzymes.
Why do people with obstructive jaundice have pale stools?Diagnosis of jaundice
Pale stool: The presence of pale stools suggests an obstructive or post-hepatic/liver cause as normal feces get their color from bile pigments. If an obstruction occurs, it prevents bile to be excreted into the intestines, causing pale or clay-colored stool.
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