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Billiary disorders
Note cards
27
Nursing
Undergraduate 2
04/29/2013

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Cards

Term
Who gets Gall bladder disease?
Definition
The 4 F's:Forty,Female,Fat,Fertile
Term
What is Gallbladder disease patho?
Definition
Cholelithiasis
-Cholesterol stones
-Pigmented stones
Cholecystitis
Term
What are some health history questions you would ask for Gallbladder disease?
Definition
-What are your food preferences?
-Do you have any GI symptoms occur after eating fatty foods?
-Belching?
-Abdominal pain? Precipitating
Quality
Region(where)
Severity
Time(how long, when)
Term
What tests are done to diagnose gallbladder disease?
Definition
Ultrasound(75%accurate,less expensive)
Gallbladder scan(HIDA scan)
Cholangiogram
Term
What would you want to check and have done before doing a HIDA scan?
Definition
Check if patient has any allergies because you have a dye that will be administered and you want the consent form signed
Term
What is a Cholangiogram doing?
Definition
Its an xray of the bile ducts and the patient is also given dye for this procedure
Term
What is ERCP?
Definition
Endoscopic Retrograde Cholangio Pancreatograpgy
Term
What are some things to know and assess for a ERCP?
Definition
-NPO 8 hrs
-Concious sedation
-Assess gag reflex and abdominal pain post procedure
Term
What are some facts about Acute Cholecystitis?
Definition
-Sudden onset
-Sever steady pain
-Almost always begins without infection, but may lead to infection
-95% will have gallstones
-Acalculous Cholecytitis
Inflammation:whi will have GB fill with fluid and the walls will get thicker
Term
When can you get Acalculous Cholecystitis?
Definition
-after major sugery
-Long time IV feeding
-Burns
-Septic
-Immune issues
-Young kids d/t other viral infections
Term
What are some s/s of Chronic Cholecytitis?
Definition
Jaundice
Clay colored stools
dark urine
results from gallstones
Gallbladder damage
Steatorrhea(fat in stool)
Insidious Symptoms(which develop slowly)
Term
What are some s/s of gallbladder disease after eating a fatty meal?
Definition
RUQ pain radiating to back, right shoulder
INdigestion
N/V
UNcommonly, jaundice and clay colored feces
Term
What are some non surgical treatments?
Definition
Hospitalization
Npo(let stomach rest
IVF'sNG
Antibiotics
Pain Meds-Morphine Sulfate-Dilaudid
Antiemetics-Zofran
Term
What do you use to drain the bile out of the gallbladder?
Definition
Percutaneous Transhepatic Billiary Catheter
Term
What is another nonsurgical way to treat gallbladder disease?
Definition
ESWL( Extracorporeal Shock Wave Lithtripsy) and pt may feel some pain
Term
What is a surgical treatment of gallbladder disease?
Definition
Laparoscopic Cholcystectomy
Term
What are some complications of a lap chole?
Definition
Resp. depression
Post op bleeding
wound infection
Term
what kind of cholecystectomy is rarly used today and may be used sometimes in the 3rd trimestr of pregnancy?
Definition
OPEN Cholecystectomy
Term
What is a Choledochostomy?
Definition
Its a incision in the common bile duct to remove stones and a T tube is inserted into the common bile duct
Term
When is the T tube usually removed?
Where do you want to keep it?
What can happen if bile backs up?
Definition
<4hrs after surgery
Keep it below the waist
Infection
Term
What are some post-op implications?
Definition
-Freq. VS(including O2)
-Pain assessment
-TCDB
-Encourage fluids
-Monitor N/V
-T-tube
-JP drain
HOB elevated
Early ambulation(toget rid of CO2)
-Surgical site assessment
-May be on A PCA
-No food until fully awake and gag reflex is back
Term
What are some discharge instructions?
Definition
-persistant fever over 101 degrees F
-Bleeding
-increasing abdominal swelling
-Persistant cough or SOB
-Purulent drainage
-Pain that is not relieved by meds
-Persistant N/V
-Chills
-Redness that is surrounding incisions that is worsening or getting bigger
-Do NOT pull off steri strips let come off by themselves
-Can begin to eat after 1 week
-R shouldre pain may still be present still get up and walk
-may go back to wor 3-4 days(Lap Chole)
Couple weeks(Open Chole)
Term
What does Naproxen(Naprosyn) cause?
Definition
GI upset
Term
Which race has a higher incidence of gallbladder disease because of a problem with ETOH?
Definition
American Indians
Term
What would require immediate intervention post esophagectomy?
Definition
RR of 28
Term
What is the greates risk for developing in the treatment of cancer?
Definition
Stomatis(thrush)
Term
If the pt has bad oral hygein how often would you iniate oral care?
Definition
q6h
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