Learning Guide for Gall Bladder and Pancreas
1.
A forty year old African American female is admitted with suspected cholecystitis. Health
history reveals the following data:
Height 63 inches; weight 180 lbs
Gravida 6; para 5
Drinks 3 beers per night
Hypertension for past 5 years
Walks 2 miles each day
Current medications: Birth control pills, anti-lipedmic, diuretic and multivitamins
Identify all of the risk factors that could contribute to cholecystitis for this client.
2.
3.
Fill in the blanks related to complications of gall bladder disease.
A.
A nurse would expect a client with acute cholecystitis to most likely have pain in
the _______________ quadrant.
B.
Decreased bowel sounds in a client with cholecystitis indicates the impending
development of an ________________.
C.
A client is admitted with a possible perforated gall bladder, the nurse should
assess for signs of __________________________.
D.
Pain associated with acute cholecystitis increases the client’s risk of developing
______________________________.
E.
An obstructed common bile duct causes backflow of _______________ into the
___________________________.
Compare and contrast the following manifestations of gall bladder disease.
Acute Cholecystitis/
Cholelithiasis
Chronic Cholecystitis
Common Bile Duct
Obstruction
4.
Briefly describe the nursing responsibilities for each of the following diagnostic tests and
the expected findings for a client with gall bladder disease:
a. Ultrasound
b. HIDA scan
c. Cholecystogram
5.
List 5 priority nursing diagnoses for clients with gall bladder disease.
6.
What factors should the nurse consider when administering analgesics for with acute
cholecystitis?
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7.
A client with cholelithiasis has an increase in serum amylase and lipase. What does this
indicate?
8.
Explain the purpose of a low fat diet for a client with gall bladder disease.
9.
A client with gall bladder disease is at risk to develop a deficiency in vitamin __________.
Explain why this might occur.
10.
Describe the nursing responsibilities when caring for a client with a T tube.
11.
Summarize the pathophysiologic changes that occur with pancreatitis.
12.
Indicate if the following statements related to complications of pancreatitis are true or
false.
_______Vasodilation caused by pancreatic enzymes leads to hemorrhage.
_______Insufficient trypsin causes impaired carbohydrate metabolism.
_______Disruption of fat metabolism causes hypokalemia.
_______Decreased plasma proteins contribute to the development of ascites.
13.
How will symptoms vary for acute versus chronic pancreatitis?
14.
Match each of the following manifestations of pancreatitis with the related cause. Some
answers may be used more than once.
____
Nausea and vomiting
A.
Decreased calcium
____
Cullen’s sign
B.
Cell necrosis
____
Grey Turner’s spots
C.
Bleeding into tissue
____
Steatorrhea
D.
Impaired digestion
____
Atelectasis
E.
Decreased fat absorption
____
Chvostek's sign
F.
Decrease depth of respiration
____
Trousseau’s sign
____
Elevated amylase
15.
Complete each of the following nursing diagnoses for a client with pancreatitis.
Assessment
Diagnosis
Pain
Implementation
Fluid volume deficit
Decreased airway clearance
2
Altered nutrition less than body
requirements
Risk for infection
Risk for injury: hypocalcemia
16.
Identify 3 medications that may be used in the treatment of pancreatitis and give the
purpose of each one.
17.
List 3 nursing interventions to prevent respiratory complications in a client with
pancreatitis.
18.
Explain how each of the following interventions will contribute to increase comfort for a
client with pancreatitis:
a.
b.
c.
d.
e.
f.
g.
Semi-Fowler’s position
Nasogastric suction
Peritoneal tap
TPN
Low fat diet
Elimination of caffeine and alcohol from diet
Digestive enzymes
19.
Develop a 24 hour meal plan for a low fat diet.
20.
Evaluate the following data for a client with pancreatitis.
Data
Initial BP 112/76; 1 hour later BP 88/50
Evaluation/Modification
Newly absent bowel sounds
Client sleeping in fetal position
Client found crying
Chocolate candy bar found in room
Dyspnea with respirations of 32/minute
Frequent requests for pain med
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