Acute Calculous Cholecystitis Overview
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Questions and Answers

What is the most common cause of acute cholecystitis, and what percentage of cases does it account for?

The most common cause of acute cholecystitis is complete cystic duct obstruction due to impacted gallstones, accounting for about 90 percent of cases.

According to O’Rourke et al. (2023), what percentage of patients with acute cholecystitis have gallstones?

About 95 percent of patients with acute cholecystitis have gallstones.

What is the estimated percentage of patients with asymptomatic gallstones that will develop symptoms within 20 years?

Only about 20 percent of patients with asymptomatic gallstones will develop symptoms within 20 years.

What is considered the most appropriate management for symptomatic patients with cholecystitis?

<p>Laparoscopic cholecystectomy is considered the most appropriate management for symptomatic patients with cholecystitis.</p> Signup and view all the answers

What risk factors are particularly significant in the diagnosis of acute calculous cholecystitis?

<p>Significant risk factors include obesity, advanced age, and metabolic syndromes.</p> Signup and view all the answers

How do chronic conditions, such as hypertension, complicate the management of patients undergoing surgery for acute cholecystitis?

<p>Chronic conditions like hypertension complicate surgical interventions and recovery, necessitating a meticulous management plan.</p> Signup and view all the answers

What classic symptoms are associated with acute cholecystitis?

<p>Classic symptoms of acute cholecystitis include severe right upper quadrant pain, fever, and leukocytosis.</p> Signup and view all the answers

What is the significance of individualized management plans in the context of patients with acute cholecystitis and hypertension?

<p>Individualized management plans are crucial for addressing the complexities of perioperative care in patients with pre-existing comorbidities like hypertension.</p> Signup and view all the answers

What significant health event did Patient T experience in 2013?

<p>Patient T was admitted to the hospital due to an ischemic stroke.</p> Signup and view all the answers

When did Patient T undergo a surgical procedure for a gallbladder issue, and what was the reason for it?

<p>Patient T had a laparoscopic cholecystectomy on October 10, 2024, due to acute calculous cholecystitis caused by gallstones.</p> Signup and view all the answers

What was the recorded respiratory rate of Patient T on October 14, 2024, and is it within normal limits?

<p>Her respiratory rate was 19 cycles per minute, which is within the normal range.</p> Signup and view all the answers

What symptoms did Patient T experience post-operatively related to her respiratory function?

<p>She exhibited a productive cough with yellow sputum and had crackles in her lung sounds.</p> Signup and view all the answers

What was Patient T's oxygen saturation levels measured at, and what does this indicate?

<p>Her oxygen saturation levels were measured at 96%, indicating adequate oxygenation.</p> Signup and view all the answers

What notable family health conditions contribute to Patient T's medical history?

<p>Patient T has a family history of hypertension and cardiovascular diseases, with relatives dying from heart attacks.</p> Signup and view all the answers

How much did Patient T smoke before her hospital admission, and what is the significance of this statistic?

<p>She smoked 1 pack of cigarettes per day, totaling 7,300 cigarettes in 34 pack years since 1990.</p> Signup and view all the answers

What intervention was administered to Patient T to assist with her respiratory condition?

<p>Salbutamol nebulization was administered as advised by the physician.</p> Signup and view all the answers

What is the chief complaint of Patient T upon admission to the hospital?

<p>Severe abdominal pain rated 10/10.</p> Signup and view all the answers

What significant chronic conditions does Patient T have in her medical history?

<p>Hypertension, angina, and a previous ischemic stroke.</p> Signup and view all the answers

What diagnostic imaging was performed on Patient T, and what did it reveal?

<p>An abdominal ultrasound was performed, revealing gallstones in the gallbladder.</p> Signup and view all the answers

What was the patient's blood pressure upon admission, and how is it classified?

<p>140/70 mmHg, classified as controlled hypertension.</p> Signup and view all the answers

What surgical procedure was scheduled for Patient T, and why?

<p>A laparoscopic cholecystectomy; it was needed to address her acute calculous cholecystitis.</p> Signup and view all the answers

What is the first step in managing a patient with acute calculous cholecystitis?

<p>Conducting a thorough and systematic assessment.</p> Signup and view all the answers

How is Patient T's respiratory support being managed?

<p>Her respiratory support is set at 1 liter per minute via nasal cannula.</p> Signup and view all the answers

What specific nursing interventions are included in Patient T's care plan?

<p>Pain management, monitoring vital signs, and assessing neurological status.</p> Signup and view all the answers

Why is closely monitoring vital signs important in patients with acute calculous cholecystitis?

<p>To identify any potential infections and assess the patient's overall stability.</p> Signup and view all the answers

What factors contributed to Patient T's abdominal pain, as reported by her family?

<p>The abdominal pain had been worsening over two months, accompanied by intermittent vomiting.</p> Signup and view all the answers

What role does pain assessment play in the care plan for these patients?

<p>It helps manage significant right upper quadrant pain and evaluates the effectiveness of pain relief interventions.</p> Signup and view all the answers

What are some diagnoses included in the individualized care plan for this condition?

<p>Acute pain related to inflammation, risk for infection, and impaired physical mobility.</p> Signup and view all the answers

What strategies can be implemented to prevent infection in a patient with acute calculous cholecystitis?

<p>Monitoring for signs of infection and ensuring proper hand hygiene.</p> Signup and view all the answers

How should dietary modifications be approached for patients recovering from acute calculous cholecystitis?

<p>By reducing fatty and oily foods and possibly collaborating with a dietitian.</p> Signup and view all the answers

Why is encouraging mobility important for patients with this condition?

<p>To prevent complications related to immobility, such as venous thromboembolism.</p> Signup and view all the answers

What is emphasized in providing emotional support to these patients?

<p>The importance of lifestyle changes for long-term health.</p> Signup and view all the answers

What are the primary symptoms associated with gallstones?

<p>Common symptoms include abdominal pain, nausea, vomiting, and indigestion.</p> Signup and view all the answers

How does acute cholecystitis differ from chronic gallbladder disease?

<p>Acute cholecystitis is a sudden inflammation of the gallbladder, while chronic gallbladder disease is a long-standing condition often resulting from repeated episodes of inflammation.</p> Signup and view all the answers

What nutritional considerations are important for patients with gallbladder disease?

<p>Patients should follow a low-fat diet and avoid foods that trigger symptoms.</p> Signup and view all the answers

What is the first-line treatment for acute cholecystitis according to recent guidelines?

<p>Laparoscopic cholecystectomy is often the first-line treatment for acute cholecystitis.</p> Signup and view all the answers

What role does patient education play in managing gallstone disease?

<p>Patient education helps individuals understand their condition and manage symptoms effectively.</p> Signup and view all the answers

What are the potential complications of untreated gallstones?

<p>Complications may include acute cholecystitis, pancreatitis, and jaundice.</p> Signup and view all the answers

How do lifestyle factors contribute to the development of gallstones?

<p>Obesity, high-fat diets, and sedentary lifestyle increase the risk of gallstone formation.</p> Signup and view all the answers

What postoperative care strategies are important for patients after gallbladder surgery?

<p>Patients should manage pain effectively and adhere to dietary guidelines to promote recovery.</p> Signup and view all the answers

What is the primary focus of the discharge plan for Patient T following her surgery?

<p>The primary focus is on establishing a structured daily routine, educating about medication adherence, and implementing dietary modifications.</p> Signup and view all the answers

Why is it important for Patient T to recognize signs of potential complications post-surgery?

<p>Recognizing signs of complications such as fever or increased pain is crucial for timely intervention and preventing serious health issues.</p> Signup and view all the answers

Describe the significance of nursing care in the context of Patient T's case.

<p>Nursing care is significant as it addresses both her post-operative condition and her existing chronic issues like hypertension and stroke history.</p> Signup and view all the answers

What role does medication adherence play in Patient T's recovery?

<p>Medication adherence is vital for infection prevention, pain management, and assisting bile flow, which are critical for her post-operative recovery.</p> Signup and view all the answers

How do dietary modifications contribute to Patient T's health management?

<p>Dietary modifications, particularly a low-fat and low-oil diet, help prevent exacerbation of gallbladder issues and support digestive health.</p> Signup and view all the answers

What does a collaborative healthcare approach entail in the care of Patient T?

<p>A collaborative healthcare approach involves teamwork among the patient, family, and various healthcare professionals like physical therapists and dietitians.</p> Signup and view all the answers

Identify two specific health risks Patient T faces post-surgery and suggest how they can be addressed.

<p>Patient T faces risks of bradycardia and orthostatic hypotension, which can be addressed through tailored guidance on mobility and regular monitoring of her vital signs.</p> Signup and view all the answers

What educational aspects were emphasized to Patient T and her caregiver?

<p>Education emphasized medication adherence, recognizing signs of complications, and implementing dietary modifications.</p> Signup and view all the answers

Study Notes

Acute Calculous Cholecystitis

  • A prevalent inflammatory condition of the gallbladder
  • Occurs when the cystic duct is obstructed by gallstones
  • Leading to irritation, inflammation, and potential necrosis of the gallbladder wall
  • Risk is more prevalent in women aged 40 years and above, and can run in families
  • Cholecystitis develops in up to 10% of patients with symptomatic gallstones (90% of cases caused by complete cystic duct obstruction)
  • 95% of patients with acute cholecystitis have gallstones
  • Asymptomatic gallstones may not be treated, as issues may arise after 20 years
  • Symptomatic patients often undergo laparoscopic cholecystectomy
  • Comorbidities like hypertension can complicate surgical interventions and recovery

Health Profile

  • Patient T is a 56-year-old female, widowed, currently living with a partner in Lower Palalan, Lumbia, Cagayan de Oro City
  • History of hypertension, angina, and a previous ischemic stroke
  • Chief complaint of intense abdominal pain (10/10), in the right upper quadrant (RUQ), frequent nausea, and vomiting
  • Two months prior to admission, experienced intermittent sharp RUQ pain associated with vomiting
  • Severe abdominal pain rated 10/10 on the pain scale, particularly in the right upper quadrant, for the previous two months, accompanied by intermittent vomiting

Comprehensive Nursing Assessment (October 14, 2024)

  • Respiratory Rate: 19 cycles per minute (cpm)
  • Productive Cough with yellow sputum indicative of secretions and airway obstruction.
  • Oxygen saturation levels: 96% with oxygen support at 2 liters per minute
  • Blood pressure recorded at 140/70 mmHg; heart rate at 57 beats per minute (bpm), indicative of bradycardia showing adequate perfusion
  • Full alertness and orientation, with a Glasgow Coma Scale (GCS) score of 15
  • Mild body weakness, however, normal motor function and sensation with effective coordination
  • Reported consuming a typical diet (e.g., fried chicken, pork chop, stir-fried vegetables)
  • No issues with swallowing, indicating the absence of dysphagia.
  • Patient depended on partner for daily chores.

Comprehensive Nursing Assessment (October 15, 2024)

  • Respiratory Rate: 18 cycles per minute (cpm)
  • Decreased discomfort from her cough, showing effectiveness of nebulization therapy from previous assessment
  • Blood pressure recorded at 130/80 mmHg; heart rate improved to 68 bpm; good perfusion
  • Full alertness and orientation
  • Normal bowel function
  • Patient still reported numbness in her lower extremities
  • Patient's daily dietary intake remained consistent with a balanced consumption of three meals a day, including soups, and lessening intake of oily foods
  • Patient still depended on partner for daily activities of daily living (ADLs)

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Description

This quiz covers the key aspects of Acute Calculous Cholecystitis, including its causes, symptoms, and treatment options. It discusses the demographics affected by the condition and the surgical interventions available for symptomatic cases. Additionally, it examines how comorbidities can impact patient recovery.

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