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Questions and Answers
What is the most common type of gallstone found in the pediatric population today?
Gallbladder disease in children is primarily associated with obesity.
False
What are some clinical manifestations of gallbladder disease during pregnancy?
Pain, nausea, vomiting, intense itching, jaundice, dark-colored urine
The incidence of gallbladder disease increases during __________ because of physiological changes.
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What has been reported as a common nonobstetrical reason for surgery during pregnancy?
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Match the age groups with their respective cholecystectomy complication rates:
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Nonoperative methods for treating gallbladder stones in older adults should be further explored.
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What is the relationship between the number of pregnancies and gallbladder disease incidence?
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Which of the following is NOT a common problem for patients with cholelithiasis or cholecystitis?
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Nursing assessment for gallbladder disease should only focus on physical examination findings.
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What dietary modifications should a patient with gallbladder disease focus on?
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Patients with gallbladder disease often experience pain in the _____ quadrant of the abdomen.
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Match the following symptoms with their significance in gallbladder disease:
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Study Notes
Gallbladder Disease in Children and Adolescents
- Pediatric gallbladder disease was previously often linked to underlying conditions causing hemolysis and bilirubin release.
- This type of gallstone is still prevalent at a stable 15%.
- Cholesterol gallstones have become the dominant type due to rising pediatric obesity.
- Cholecystectomy for cholesterol gallstones has increased dramatically, over 200%.
Gallbladder Disease in Pregnant Women
- Pregnancy physiology increases the incidence of gallbladder disease.
- Symptoms during pregnancy include pain, nausea, vomiting, itching, jaundice, and dark urine.
- Gallbladder disease frequently requires surgery during pregnancy.
- Maternal-fetal outcomes are generally better with surgery during pregnancy than waiting until after childbirth.
- Gallbladder disease is common in the first year postpartum, and the incidence of biliary sludge and gallstones is linked to the number of pregnancies and age at pregnancy.
Gallbladder Disease in Older Adults
- Older adults may present with vague gallbladder disease symptoms, such as malaise or lack of appetite.
- Surgery poses higher risks for older adults, leading to increased ICU admissions and mortality.
- For those 70 years of age or older, ICU admissions were 14.1% vs. 4% in younger patients, and mortality was 6.5% vs. 0.6% in both elective and emergent cases.
- Exploration of non-surgical treatments for gallbladder stones in older adults is recommended.
Nursing Care of the Patient with Gallbladder Disease
- Nursing care focuses on patient teaching, pain management, and healthy nutrition guidance.
### Assessment
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The nurse observes and interviews the patient to assess current manifestations, including:
- Right upper quadrant (RUQ) pain, its character (e.g., sharp, dull, cramping), relationship to meals, duration, and radiation
- Nausea and vomiting
- Other symptoms (e.g., fever, chills, jaundice)
- Duration of symptoms
- Risk factors or previous history of symptoms
- Chronic diseases such as diabetes, cirrhosis, or inflammatory bowel disease (IBD)
- Current diet
- Use of oral contraceptives or possibility of pregnancy
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The nurse conducts a physical examination to assess:
- Current weight
- Color of skin and sclera
- Abdominal tenderness
- Color of urine and stool
Diagnosis
- Potential problems for patients with cholelithiasis or cholecystitis include:
- Potential for infection
- Acute pain
- Need for education on a healthy diet
Planning
- Goals of nursing care, developed in collaboration with the patient, may include:
- The patient will demonstrate no signs or symptoms of infection.
- The patient will report adequate pain control.
- The patient will verbalize understanding of a low-fat diet with adequate intake of fat-soluble vitamins.
- The patient will verbalize awareness of symptoms that require immediate notification of the healthcare provider (HCP).
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Description
Explore the complexities of gallbladder disease in children, adolescents, and pregnant women. This quiz covers the increasing prevalence of cholesterol gallstones, the impact of obesity, and the significance of timely surgical interventions during and after pregnancy. Test your knowledge on symptoms, treatment, and maternal-fetal outcomes.
