Cholecystitis (Gallbladder Inflammation) Notes PDF

Cholecystitis - inflammation of the gallbladder. Cholelithiasis - Small stones that are usually made of cholesterol and can form in the gallbladder or the common bile duct. It may lead to complications such as: Acute pancreatitis: When a gallstone blocks the pancreatic duct, leading to...

Cholecystitis - inflammation of the gallbladder. Cholelithiasis - Small stones that are usually made of cholesterol and can form in the gallbladder or the common bile duct. It may lead to complications such as: Acute pancreatitis: When a gallstone blocks the pancreatic duct, leading to inflammation of the pancreas Bile duct infection (cholangitis): Inflammation of the bile duct due to bacterial infection caused by the blockage Liver damage: Prolonged bile duct obstruction can lead to liver damage RiskFactors of Cholecystitis Female clients over age 40 Multiparous women - a woman who has given birth to more than one child. Obesity Oral contraceptives use - Estrogen and progesterone in oral contraceptives can increase the risk of gallstones. Estrogen increases cholesterol levels in bile, which can lead to cholesterol crystal formation. Elevated serum cholesterol levels Increased estrogen in the body - increased secretion of cholesterol in the biliary duct Family history Common Signs and Symptoms: Colicky pain RUQ due to gallbladder trying to contract to get the bile to flow intermittently Pain radiating to right shoulder and to the back Pain gets worse after about 30 minutes as gallbladder tries to release the bile Nausea/vomiting Localized guarding Positive Murphy Sign - Press the right side of the rib cage, medial to the midclavicular line before asking the patient to take a deep breath. This moves the liver and gallbladder down toward the examiner's hand causing the patient to halt inspiration due to pain if gallbladder is inflamed. Fever, tachycardia Leukocytosis PERFORATION happens: Complication: PERITONITIS - diffuse abdominal tenderness and rigidity. Call the HCP stat. Perforation of gallbladder leads leakage of bile to the abdominal cavity. Bile will irritate the muscles causing rigidity. High risk of bacterial growth leading to sepsis. Patient may be reporting prior history of indigestion when eating fatty foods. Manifestation of indigestion are bloating, heart burn or flatulence. NURSING INTERVENTION Abdominal ultrasound to confirm diagnosis Undergoing surgery known as cholecystectomy (laparoscopic or open cholecystectomy) Pre-Operative Care: Pain Management (opioids, or NSAIDs) Administer fluid and electrolytes esp. due to vomiting episodes IV antiemetics IV antibiotics prophylaxis Keep client on NPO Postoperative Care: Ambulation to reestablish peristalsis and prevent bowel obstruction post-op Increase fluid intake following proper diet Low-fat diet initially -- regular diet after few weeks