Biliary Disorders
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Questions and Answers

What is the primary type of gallstones that account for 75% of cases?

  • Pigment stones
  • Cholesterol stones (correct)
  • Bile duct stones
  • Calcium stones

Which statement accurately describes a common risk factor for developing gallstones?

  • Low-fat diet and high exercise levels
  • Obesity and multiple pregnancies (correct)
  • Frequent liver function tests
  • Young age and males

Which symptoms are commonly associated with gallstones?

  • Severe pain in the lower left quadrant
  • Nausea after light meals
  • Epigastric distress and RUQ pain radiating to the shoulder (correct)
  • Loss of appetite and weight gain

Which dietary recommendation is suggested for patients with cholelithiasis?

<p>Low fat diet including fruits and vegetables (D)</p> Signup and view all the answers

What is a potential postoperative complication that should be assessed in patients after gallbladder surgery?

<p>Respiratory complications (A)</p> Signup and view all the answers

What is the primary purpose of Endoscopic Retrograde Cholangiopancreatography (ERCP)?

<p>To visualize the biliary system using fiberoptic technology (A)</p> Signup and view all the answers

Before undergoing ERCP, what is required from the patient?

<p>Be NPO for several hours prior (A)</p> Signup and view all the answers

Which dietary modification is recommended for patients undergoing medical management for gallstones?

<p>Low fat diet (A)</p> Signup and view all the answers

What is an important consideration to monitor post-diagnostic procedure when dye is used?

<p>BUN levels for proper secretion (B)</p> Signup and view all the answers

What is the main surgical treatment for cholelithiasis?

<p>Laparoscopic cholecystectomy (A)</p> Signup and view all the answers

What should a patient do to alleviate discomfort after a laparoscopic cholecystectomy?

<p>Sit upright and use a heating pad (C)</p> Signup and view all the answers

Which symptom indicates a potential infection after a laparoscopic cholecystectomy?

<p>Temperature of 37.7°C (100°F) or more for 2 consecutive days (A)</p> Signup and view all the answers

What post-operative instruction is important for patients after lithotripsy?

<p>Anticipate bruises at the site of shock waves (D)</p> Signup and view all the answers

Which symptom is strongly associated with cholecystitis?

<p>Nausea and vomiting after fatty foods (C)</p> Signup and view all the answers

What lifestyle factor significantly increases the risk of developing chronic pancreatitis?

<p>Alcoholism (C)</p> Signup and view all the answers

Which laboratory finding is indicative of acute pancreatitis?

<p>Serum amylase and lipase greater than three times the normal level (D)</p> Signup and view all the answers

What is one of the main nursing care priorities for a patient with acute pancreatitis?

<p>Monitor fluid and electrolyte balance (B)</p> Signup and view all the answers

What is a classic symptom of chronic pancreatitis?

<p>Frothy, foul-smelling stools (C)</p> Signup and view all the answers

Which of the following is NOT a risk factor for cholecystitis?

<p>Increased physical activity (B)</p> Signup and view all the answers

What is a potential complication after a pancreaticoduodenectomy (Whipple procedure)?

<p>Bleeding (A)</p> Signup and view all the answers

The initial management of acute pancreatitis typically includes which of the following?

<p>Starting an NPO (nothing by mouth) regimen (B)</p> Signup and view all the answers

Which condition is NOT a common complication of acute pancreatitis?

<p>Gastroesophageal reflux disease (GERD) (C)</p> Signup and view all the answers

What is the primary treatment for cholecystitis?

<p>Surgery to remove the gallbladder (D)</p> Signup and view all the answers

Which of the following diagnostic criteria is NOT associated with acute pancreatitis?

<p>Serum lipase levels below normal (C)</p> Signup and view all the answers

What is a primary goal of education for patients with chronic pancreatitis upon discharge?

<p>Teach avoidance of high-fat foods and alcohol (D)</p> Signup and view all the answers

Which symptom might indicate worsening of chronic pancreatitis?

<p>Increasing epigastric pain (C)</p> Signup and view all the answers

In managing a patient with pancreatic cancer, what is a key nursing intervention?

<p>Administer pain control measures (D)</p> Signup and view all the answers

What is a common symptom of gallstones that may not always be apparent?

<p>Silent gallstones (B)</p> Signup and view all the answers

Which of the following factors is NOT typically associated with an increased risk of developing gallstones?

<p>Diet rich in carbohydrates (B)</p> Signup and view all the answers

What could be an observable change in stool for a patient with gallstones?

<p>Gray-colored stool (A)</p> Signup and view all the answers

What type of diet is recommended for patients managing cholelithiasis?

<p>Low-fat diet (B)</p> Signup and view all the answers

Which vitamin deficiencies may result from complications related to gallstones?

<p>Vitamins A, D, E, and K (A)</p> Signup and view all the answers

What is the primary risk that must be monitored for after performing an ERCP procedure?

<p>Signs of perforation and infection (A)</p> Signup and view all the answers

Which medication is given to help dissolve gallstones during medical management?

<p>Ursodeoxycholic acid (D)</p> Signup and view all the answers

What dietary modification is recommended for patients undergoing nutritional therapy for gallstone management?

<p>Low fat diet (A)</p> Signup and view all the answers

Which of the following is a common postoperative care instruction after laparoscopic cholecystectomy?

<p>Use a heating pad for pain in the right shoulder (C)</p> Signup and view all the answers

What is the main reason for using carbon dioxide during laparoscopic cholecystectomy?

<p>To facilitate the insertion of laparoscopic instruments (B)</p> Signup and view all the answers

When monitoring BUN levels after a diagnostic procedure with dye, what is the primary concern?

<p>Risk of kidney damage (A)</p> Signup and view all the answers

After undergoing lithotripsy, patients may experience which of the following?

<p>Bruising at the site of shockwaves (A)</p> Signup and view all the answers

What symptom should prompt a patient to call their surgeon after a laparoscopic cholecystectomy?

<p>Fever above 37.7°C (100°F) for two consecutive days (C)</p> Signup and view all the answers

What is the primary nursing care approach for a patient with acute pancreatitis?

<p>Monitor amylase and lipase levels (B)</p> Signup and view all the answers

Which of the following statements regarding the risk factors of cholecystitis is true?

<p>Rapid weight loss is a significant risk factor (B)</p> Signup and view all the answers

What characteristic symptom is associated with chronic pancreatitis?

<p>Steatorrhea, which is frothy, foul-smelling stool (B)</p> Signup and view all the answers

When assessing for symptoms of acute pancreatitis, which finding is particularly significant?

<p>Severe abdominal tenderness and back pain (A)</p> Signup and view all the answers

What is the main imaging technique used to diagnose pancreatic cancer?

<p>Spiral CT scan (D)</p> Signup and view all the answers

Which laboratory finding is typically evaluated to support a diagnosis of acute pancreatitis?

<p>Amylase and lipase levels (A)</p> Signup and view all the answers

What is a common post-operative concern following a pancreaticoduodenectomy (Whipple procedure)?

<p>Change in bowel habits (D)</p> Signup and view all the answers

In patients with chronic pancreatitis, how effective are opioids for pain management?

<p>Not commonly effective in providing pain relief (A)</p> Signup and view all the answers

Which condition is a potential complication of chronic pancreatitis?

<p>Necrosis of the pancreas (C)</p> Signup and view all the answers

What is an appropriate nursing action for a patient with acute pancreatitis regarding positioning?

<p>Semi-fowlers position to alleviate pressure (A)</p> Signup and view all the answers

What dietary recommendation is crucial for patients post-acute pancreatitis?

<p>Low-fat diet to minimize strain on the pancreas (D)</p> Signup and view all the answers

What is a common early sign of pancreatic cancer?

<p>Moderate jaundice (B)</p> Signup and view all the answers

What symptom is specifically associated with underlying obstruction in acute pancreatitis?

<p>Rigid or boardlike abdomen (D)</p> Signup and view all the answers

Which of the following is a potential risk factor for developing acute pancreatitis?

<p>Gallstones and alcohol use (A)</p> Signup and view all the answers

Flashcards

Gallstones (Cholelithiasis)

Hardened deposits in the gallbladder, often cholesterol or pigment based, requiring surgical removal.

Risk factors for Gallstones

Conditions that increase the likelihood of gallstone formation. Cirrhosis, hemolysis, infections, CF, DM, weight problems, and pregnancy.

Gallstone Manifestations

Symptoms of gallstones, encompassing silent cases to severe pain, jaundice, and changes in urine/stool color.

Post-op Care for Gallstones

Nursing interventions or activities to focus on after gallbladder surgery, including encouraging activity and monitoring nutrition.

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Post-op complications of Gallbladder Surgery

Potential problems following surgery for gallstones. This may include, but is not limited to respiratory complications.

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ERCP Procedure

A procedure using fiber optic technology to visualize the biliary system (gallbladder and ducts).

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ERCP Prep

NPO (nothing by mouth) several hours prior, and moderate sedation is given.

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Post-ERCP Complications

Potential complications include perforation and infection.

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Laparoscopic Cholecystectomy

The standard surgical treatment for gallstones (cholelithiasis), involving keyhole incisions and removal of the gallbladder.

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Post-Op Lap Cholecystectomy

Post-operative care includes monitoring for infection, pain management, and activity restrictions.

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Diagnostic Dye and BUN

If a diagnostic test uses dye, monitor BUN levels to ensure proper secretion.

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Low-Fat Diet

Nutritional therapy recommendation to help manage gallstones.

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Intracorporeal Lithotripsy

Using shockwaves to break up stones inside the body.

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Cholecystitis Risk Factors

Women, obesity, diabetes, oral contraceptives/estrogen, rapid weight loss

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Cholecystitis Symptoms

Nausea/vomiting after fatty foods, RUQ pain/rigidity, Murphy's sign, fatty stools, dyspepsia

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Cholecystitis Treatment

Gallbladder removal via laparoscopy

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Acute Pancreatitis Cause

Pancreatic duct obstruction, enzyme backup leading to self-digestion

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Acute Pancreatitis Risk Factors

Gallstones and alcohol use

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Acute Pancreatitis Pain

Severe, unrelieved abdominal and/or back pain

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Acute Pancreatitis Symptoms

Severe abdominal pain, tenderness, N/V, fever, jaundice, mental confusion, rigid abdomen

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Acute Pancreatitis Diagnosis

Two of three criteria (abdominal pain, elevated amylase/lipase, imaging findings)

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Hospital Admission Criteria (Acute Pancreatitis)

Age over 55, WBC over 16,000, serum glucose over 200, LDH or AST over certain values

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Acute Pancreatitis Medical Management

NPO, NG tube, glycemic control, pain management, respiratory support

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Chronic Pancreatitis Cause

Progressive inflammation, tissue replacement, duct obstruction

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Chronic Pancreatitis Risk Factors

Alcoholism, malnutrition, smoking

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Chronic Pancreatitis Stool

Frothy, foul smelling stools with high fat content (steatorrhea)

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Pancreatic Cancer Risk Factors

Smoking, high alcohol intake

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Pancreatic Cancer Manifestations

Pain, jaundice, weight loss, ascites, hyperglycemia

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Whipple Procedure

Extensive pancreatic surgery for resectable head of pancreas cancer

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What are the risk factors for developing gallstones?

Risk factors for gallstones include: cirrhosis, hemolysis, biliary tract infections, cystic fibrosis, diabetes, weight changes (rapid loss or obesity), women, high-dose estrogen therapy, women with multiple pregnancies, and ileal resection.

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What are the common symptoms of gallstones?

Gallstones can be silent, but often cause epigastric distress, fullness, abdominal distention, vague RUQ pain, pain radiating to the back or right shoulder, biliary colic (pain, nausea, and vomiting after a heavy meal), jaundice, pruritus, changes in urine or stool color (steatorrhea, gray-colored stool), and vitamin deficiencies (A, D, E, K).

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What are some post-operative care instructions for someone who had gallbladder surgery?

Post-operative care after gallbladder surgery includes encouraging deep breathing, coughing, and early mobilization. It is crucial to maintain a low-fat diet, focusing on fruits, vegetables, and lean proteins like chicken or fish.

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What are some potential complications after gallbladder surgery?

Possible complications after gallbladder surgery include respiratory complications, such as pneumonia, due to limited lung expansion during recovery.

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What are the functions of lipase and amylase?

Lipase is a pancreatic enzyme that helps digest fats, while amylase is another pancreatic enzyme responsible for breaking down carbohydrates.

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What is Murphy's Sign?

Murphy's Sign is a clinical finding in cholecystitis where pain is elicited upon palpation of the gallbladder, causing the patient to abruptly inhale and stop breathing.

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Acute Pancreatitis Treatment

Focus is on relieving pain, preventing complications, and supporting vital functions. This includes pain management, fluid and electrolyte balance, respiratory care, and nutritional support.

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What is Steatorrhea?

Steatorrhea is a common symptom of chronic pancreatitis. It refers to fatty, foul-smelling stools due to the pancreas not producing enough digestive enzymes.

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What is a Whipple Procedure?

A Whipple procedure is a complex surgical operation for pancreatic cancer, involving removing part of the pancreas, bile duct, small intestine, and stomach.

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Study Notes

Biliary Disorders

  • Amylase and Lipase: Pancreatic enzymes aiding carbohydrate and fat digestion respectively.
  • Cholelithiasis (Gallstones): Stones formed in the gallbladder, often cholesterol-based (75%). Women are more prone. Conditions like cirrhosis, hemolysis, infections, high dose estrogen, and multiple pregnancies increase risk. Commonly presents in obese women over 40.
  • Manifestations: Silent (no pain), epigastric pain, RUQ pain, radiating to back, jaundice, pruritus, changes in urine/stool color, vitamin deficiencies (fat soluble).
  • Assessment and Diagnostics: Patient history, knowledge and education needs, respiratory status and nutritional status.
  • Post-Operative Care: Turning, coughing, deep breathing exercises; low-fat diet recommended (fruits, vegetables, lean proteins). Assess for bleeding and other complications, monitor vital signs.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP): Procedure to visualize the biliary system, using endoscopy, moderate sedation. Post procedure: monitor for perforation/infection, BUN levels if dye used.
  • Medical Management: Low fat diet, Ursodeoxycholic acid and chenodeoxycholic acid to potentially dissolve gallstones. ERCP. Laparoscopic cholecystectomy is a standard surgical treatment.

Cholecystitis

  • Risk factors: women, obesity, diabetes, oral contraceptives, and rapid weight loss.
  • Symptoms: nausea, vomiting, pain in RUQ radiating to shoulder, Murphy's sign (pain with palpation), fatty stools, dyspepsia, belching, jaundice, clay stools, dark urine, pruritus.
  • Diseases like HIV/AIDs increase risk, if ruptured: check CBC values.
  • Treatment: remove gallbladder via laparoscopy; supportive care and dietary management; low-fat diet, fluids, pharmacological therapy, like ursodeoxycholic acid (UDCA) and/or chenodeoxycholic acid (CDCA).

Acute Pancreatitis

  • Cause: Pancreatic duct obstruction, causing pancreatic enzymes to back up, leading to autodigestion. Gallstones and alcohol use.
  • Risk Factors: Alcoholism, malnutrition, smoking.
  • Symptoms: Severe abdominal pain, abdominal tenderness back pain, decreased peristalsis, nausea, vomiting, fever, jaundice, mental confusion, epigastric pain, rigid/board-like abdomen, ecchymosis in flank area, agitation.
  • Diagnosis: History of upper abdominal pain; amylase and lipase are highly elevated, imaging. Labs including amylase, lipase, CBC, WBC, UA.
  • Medical: NPO, NG tubes; glycemic control; respiratory monitoring; pain management with opioids; H2 antagonists.
  • Nursing: Monitor amylase, lipase, VS, I&O, fluid and electrolyte imbalances, breathing. Pain and discomfort relief, nutritional support, skin integrity.

Chronic Pancreatitis

  • Cause: Progressive inflammatory disorder with fibrous tissue replacement of pancreatic tissue. Leads to pressure increases in the ducts.
  • Risk Factors: Alcoholism, malnutrition, smoking.
  • Symptoms: Frequent attacks of severe upper abdominal and back pain; vomiting, weight loss, steatorrhea (frothy, foul-smelling stools with high fat content).
  • Diagnosis: Clinical presentation, lab work, imaging.
  • Treatment: Addressing pain; nutritional management (low-fat diet); managing complications like steatorrhea. Reduce risk factors (e.g., smoking).

Pancreatic Cancer

  • Risk Factors: Smoking, high alcohol intake.
  • Signs: Nonspecific (pain, jaundice, weight loss, ascites, hyperglycemia).
  • Diagnosis: Spiral CT, MRI, ERCP.
  • Treatment: Surgery, radiation therapy, chemotherapy, palliative care, symptom management.

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Biliary Disorders Chapter PDF

Description

This quiz covers essential concepts related to biliary disorders, including gallstones, pancreatic enzymes, and diagnostic assessments. Explore the manifestations and post-operative care approaches for managing these conditions. Ideal for healthcare professionals and students seeking to deepen their understanding of biliary health.

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