lOMoARcPSD|39714877
Cholecystitis Concept Map
Adult Health II Medical-Surgical Nursing Concepts And Practi (University of North
Florida)
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lOMoARcPSD|39714877
Definition:
Types:
Gallstones made of
bile, calcium
cholesterol, and
proteins block
common bile and
Cholesterol
gallstones
Causes:
Abnormal
metabolism of
bile salts and
cholesterol
Abscess,
perforation,
peritonitis
Diagnostics
Xray for stones
History of high fat, low
fiber diet
Females over 40,
white/Mexican
American/Native
American
Nausea, vomiting,
steatorrhea
Obesity, excess
cholesterol, HLD
Sedentary lifestyle
Hormones, gastric
bypass
Ultrasound for edema and
fluid
ERCP/MRCP
HIDA Scan (radioactive
tracer with gamma cams)
Interventions
Pain management
Weight Loss
Medications
Critical rescue for biliary
colic
Jaundice, dark urine
Tachycardia
Dyspepsia, eructation,
Changes in serum
amylase and lipase
(altered pancreas
function)
Cholecystitis
Risk Factors
RUQ pain, dehydration,
fever (may present as
delirium in older adults)
Changes in AST,
LDH, ALP, bilirubin
Necrosis
Signs and Symptoms:
Blumberg Sign (rebound
tenderness)
Increased WBC
(inflammation)
Ischemia,
infection
Pigment
gallstones
Calculous
(stones)
Labs:
Potential
Outcomes
Surgery or procedures
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lOMoARcPSD|39714877
Pain
Management
Weight Loss
Surgery/Procedures
IV fluids
Lap chole
Opioids or
NSAIDs
Pain
medications
Open Chole
Antibiotics for
infection
Smaller,
frequent meals
Avoiding
greasy, spicy,
fatty goods
Monitor labs
Consult with
Percutaneous
transhepatic biliary
cath
Extracorporeal
shock wave
lithotripsy
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Medications
Ursodiol,
chenodiol (break
down gallstones)
Critical Rescue
Biliary colic =
gallstone
obstruction with
duct spasm which
can lead to shock
lOMoARcPSD|39714877
Acute Cholecystitis
Chronic Cholecystitis
Calculous or acalculous
Calculous or episodes
of cystic duct
obstruction
Inflammation, edema,
obstruction
Decreased motility,
decreased bile
emptying
Gallbladder fibrosis,
atrophy
Decreased motility,
decreased absorption
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