Learning about Cholecystitis
Cholecystitis is an inflammatory condition of the gallbladder, commonly caused by gallstones. It is important for nursing students to recognize early signs, assess, and treat the patient as soon as possible.
I personally had cholecystitis when I was 15 years old. For many months, I was experiencing the worst RUQ pain, nausea, vomiting. I had seen multiple doctors that ran blood work and did a physical exam that couldn’t give me a reason why I was so sick. Until I had finally seen a gastrointestinal doctor that did a CT scan of the abdomen that found I had many gallstones in my gallbladder.
One the size of a golf ball. I went to a surgeon and made the appointment to get my gallbladder removed. Interesting to be told at 15, I was his youngest patient ever to be diagnosed with Cholecystitis. I had a successful surgery removing my gallbladder, but it took weeks to fully recover. Now, I had to completely change my diet around avoiding high fatty foods. Plus changing from dairy to non-dairy products.
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Cholecystitis, a condition marked by the inflammation of the gallbladder, can bring about significant discomfort and health concerns. Typically triggered by gallstones obstructing the ducts that carry bile, this inflammation results in abdominal pain, often accompanied by nausea, vomiting, and fever. Left untreated, cholecystitis can lead to serious complications, such as infections and tissue damage.
Diagnosing the condition involves a combination of physical examination, imaging tests, and laboratory assessments. Treatment options range from pain management and dietary adjustments to surgical removal of the gallbladder, known as a cholecystectomy. Swift medical attention and adherence to recommended treatments are essential in managing cholecystitis and preventing potential complications.
Overview on Cholecystitis
1. Acute or chronic inflammation of the gallbladder.
a. It is caused by cholelithiasis (gallstones), duct obstruction, and infection
2. Gallbladder stores and secretes bile into the duodenum to aid in digestion of fats
3. Uncorrected can lead to liver damage
a. Assessment
b. N/V
c. RUQ pain→ Occurs 2-4 hours after high fat meals and lasts 1-3 hours
d. Murphy’s Sign
i. Pain with expiration while the examiner's hand is placed below the costal margin on right side at midclavicular line.
ii. The client then asked to inspire and if the client is unable to inspire due to pain, the test is positive.
e. Rebound tenderness over RUQ
Therapeutic Management for Cholecystitis
Therapeutic Management:1. Decrease gallbladder stimulation→ NPO, nasogastric decompression, avoid gas-forming foods
2. Antiemetics, analgesics
3. Cholecystectomy
a. Removal of gallbladder
b. Abdominal splinting when coughing
c. Clear liquids post-op, advance as tolerated/ ordered
d. T-tube drainage
i. Maintain patency of the duct
ii. High Fowler’s position
iii. Report drainage >500mL
Nursing Case Study for Cholecystitis
Patient Profile:Name: Mr. Joe Johnson
Age: 45 years old
Gender: Male
Medical History: Obesity, family history of gallbladder disease
Presenting Symptoms:
- Severe right upper quadrant abdominal pain
- Nausea and vomiting
- Low-grade fever
- Physical Examination: Mr. Johnson displayed tenderness in the right upper abdomen with guarding.
- Laboratory Tests: Elevated white blood cell count and liver enzymes
- Abdominal Ultrasound: Confirmed gallbladder inflammation and the presence of gallstones
Medical History:
Mr. Johnson had a history of obesity and a family history of gallbladder disease
Diagnosis:
Mr. Johnson was diagnosed with acute cholecystitis, an inflammatory conditions of the gallbladder
Treatment Plan:
- NPO Status:
- Mr. Johnson was kept NPO (nothing by mouth) to rest the inflamed gallbladder.
- Pain Management:
- Administered analgesics to manage severe abdominal pain.
- Antibiotic Therapy:
- Initiated broad-spectrum antibiotics to treat possible infection
- Intravenous Fluids:
- Provided intravenous fluids to maintain hydration and electrolyte balance.
- Cholecystectomy Consultation:
- Discussed surgical intervention for gallbladder removal with the surgical team
- Nutritional Education:
- Educated Mr. Johnson about dietary modifications, low-fat diet, and weight management
Outcome:
With prompt medical intervention and nursing care, Mr. Johnson’s condition improved. His abdominal pain subsided, and his vital signs stabilized. The surgical team performed a laparoscopic cholecystectomy after resolution of the acute phase.
Conclusion and Free Download
This Cholecystitis review provides essential knowledge for approaching the NCLEX with confidence. Understanding its prevention, management, and interventions empowers nurses to provide adequate care and save lives.
Are you looking for more must-know NCLEX review topics? Download our free eBook "NCLEX Flash Notes" as a valuable resource for nursing students. Encourage readers to download their free copy of the "NCLEX Flash Notes."
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