Exam (elaborations)
NUR 6111 Adv Nursing Practice 1 NUR 6111 Week 2 GI Disorders
- Institution
- William Paterson University
NUR 6111 Adv Nursing Practice 1
[Show more]
Content preview
● Cholecystitis○ Inflammation of the gallbladder, usually associated with gallstone disease, can be
acute or chronic
■ Gallstones obstruct the gallbladder-cystic duct junction, resulting in
inflammation and acute pain
■ In some cases, calculous cholecystitis, or gallbladder inflammation
without stones, is more common than obstruction of the common bile
duct.
■ Increases with age and BMI, most common in ages 50-70 years
● Females > males (2:1)
● 4 F’s (Female, Fair, Fat, Forty-Fifty)
■ Increased incidence in Native Americans
○
○ Types
■ Classic obstruction - cystic duct or junction obstruction - mild WBC
elevation, bilirubin normal, amylase/lipase normal, LFT’s slight elevation
■ Bile duct obstruction - WBC elevation, bilirubin elevated, amylase/lipase
elevated, LFT’s normal
■ Pancreatic duct obstruction - WBC elevation, bilirubin elevated,
amylase/lipase elevated, LFT’s elevated
■
○ Risk Factors
■ Pregnancy
■ Rapid weight loss (e.g., bariatric surgery)
■ Obesity
■ Gallstones
■ Surgery or trauma
, ■ Sickle cell anemia
■ Parental feeding over a prolonged period
■ Family history of gallstones
○ Clinical Presentation
■ typically present with RUQ pain, nausea, and vomiting
■ Pain may radiate from the shoulder to the scapula
■ Fever may or may not be present
○ Assessment
■ Subjective
● RUQ pain that is steady and severe, whose onset may have been
gradual or sudden with radiation to the right shoulder or back, and
has lasted at least 4-6 hours
● May report fever
● c/o nausea/vomiting
● c/o anorexia
● May report that pain started after a meal, particularly a fatty meal,
one or more hours before the onset of pain
■ Objective
● Appears ill
● May be febrile
● May be tachycardic
● Abdominal guarding
● + Murphy’s sign (to perform, have the patient take a deep breath
while palpating the area of gallbladder/ With acute choley, the
patient will respond to pain by catching their breath) is considered
highly sensitive
● May have a palpable RUQ mass
○ Differentials Diagnosis
■ Biliary colic-mild intermittent complaints
■ Peptic ulcer disease
■ Cardiac disease
■ Pancreatitis
■ Hepatitis
■ Bowel obstruction
■ Appendicitis
■ Right-sided pneumonia
○ Diagnostics
■ Labs
● CBC - leukocytosis
● CMP
● Bilirubin
● Liver Function Tests (LFT) - ALT/AST & ALP
● Amylase
● Lipase
, ● GGT
■ Diagnostics
● Abdominal Ultrasound – most specific for the presence of
stones, wall thickening, fluid, and enlargement
● HIDA scan – if negative but still suspected – uses a radioactive
tracer to view the liver, gallbladder, bile ducts, and small intestine
● MRCP (magnetic resonance cholangiopancreatography) –
magnetic resonance to visualize biliary and pancreatic ducts
● ERCP (endoscopic retrograde cholangiopancreatography) –
combines endoscopy and fluoroscopy to examine pancreatic and
bile ducts
○ Management
■ Mild attacks - avoid fatty foods and hydration
■ Severe - NPO, surgical referral
● Diverticulitis & Diverticulosis
○ Definitions
■ A diverticulum is a sac-like protrusion of the colonic wall
■ Acute diverticulitis is due to micro-perforation of the diverticulum
■ Complicated diverticulitis involves bowel obstruction, abscess, fistula or
perforation
■
○ Description
■ Inflammation of the Diverticula along the wall of the large intestine
■ Can cause severe abdominal pain, fever, nausea, and changes in bowel
habits.
■
○ Etiology
■ Diverticula develop when naturally weak places in your colon give way
under pressure
● causes marble-sized pouches to protrude through the colon wall.
■ Diverticulitis occurs when the diverticula tears, resulting in inflammation
● Aerobic and anaerobic bacteria invade diverticula, causing
infection
■ *The cause of diverticulitis is chronic constipation.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller YourAssignmentHandlers. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75632 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now