Cholecystitis
What lab values are expected in a client with cholecystitis?
Elevated WBC
Elevated Bilirubin
Elevated AST/ALT
What labs would you look for in suspected pancreatitis?
(there are 5)
Amylase
Lipase
Blood Glucose
Calcium
Triglycerides
Before performing a liver biopsy.. what must the nurse check?
and after the biopsy… what are some interventions?
Before:
Clotting formation
Empty Bladder
Consent
Vital Signs
After:
* Position on RIGHT side
bed rest for 6 hours!
Assess dressing
healing/bruising
No bilirubin reaching small intestine to be converted to urobilinogen.
severe discoloration, bruising, or swelling around the navel Indicates a positive _______’s sign.
what medications would you expect to give a patient with cholecystitis?
Morphine
Bile salt (such as cholestyramine)
Anticholinergic
Fat soluble vitamines
For a patient with pancreatitis, what medications would you expect to give?
Morphine
PPI (Pantoprazole)
LR, IV Calcium gluconate
Antibiotics (If necrotizing)
Pancreatic enzymes (creon)
Post Operative teaching for pancreaticodueodenectomy? (Whipple’s procedure)
Cough/Deep breathing
Early ambulation
Drink Plenty of fluids to avoid dehydration
Foamy, dark amber/brown urine Indicates..?
there’s Bile in urine
Increased deep tendon reflexes is a sign of what deficiency?
Hypomagnesmia
What position do you place the patient in who is post operate cholecystectomy if they have gas?
Left sims! (Left side lay with right knee flexed)
S&S Of acute pancreatitis?
(Just name a few)
Left upper quadrant pain
Nausea vomiting
Tachycardia, hypotension
fever
Cholecystectomy preoperative Patient teaching??
Postoperative care! Including dietary modifications and activity restrictions!
Jaundice indicates..?
No bile flow, bilirubin accumulating in blood
Cramping of the hand indicates a positive _________’s sign.
chvostek’s sign
What diet education would you give a patient post cholecystectomy?
Smaller more frequent meals.
Low fat diet!
How to know treatment of acute pancreatitis has improved?
Increased urine output
improved vitals/labs
improved pain levels.
Improved mental status
Patient teaching prior to ultrasound???
NPO Before! Because of abdominal contractions
Pruritus indicates..?
Bile salts in skin tissue!
With Pancrealipase what is the most important pt education?
Take medication with meals!
(breaks down fat in stools)
What are the S&S for cholecystitis?
(Just name a few, there’s a lot)
Fever/Chills
tachycardia
Prutitus
Intolerance for fatty foods
Referred pain to shoulder
Clay colored stools
Steatorrhea
Nausea/Vomiting
Diet teaching for a patient with pancreatitis?
FAT restriction. Small, BLAND, frequent meals.
Pre and Post op interventions for ERCP?
Pre:
- NPO 6-8 hr
Consent
allergies to contrast (shellfish)
Post:
Assess gag reflex, temp, abdomen, vitals
urobilinogen ABSENT in urine indicates..?
No bilirubin reaching small intestine to be converted to urobilinogen
What accessory organ disorder/disease can be associated with weight loss?
Pancreatitis