Gallbladder Disease

Question 0

Gallbladder Dz

-Hx

Answer 0

1. What did you just eat?
2. Ulcer hurts both prior to & after eating
3. Pain will vary on location of the ulcer
4. Location of the pain?

Question 1

Gallbladder Dz Vs Appendicitis

Answer 1

1. Pain is ULQ and precipitated by fatty food

2. Fatty meal causes a sludge and slows down blood flow/digestion

Question 2

Gallbladder Dz

-Complaints/Symptoms

Answer 2

1. Intense pain that lasts about 5 hrs (digestion time) ULQ
2. Stools will be white, chalky, grey color
   -Bile has not come in from the liver
   3.

Question 3

Gallbladder Dz

-Interventions

Answer 3

1. Pain medication
2. Hydration
3. Check Labs
   - Ultrasound- location / Abdominal Xray- calcification of stones

Question 4

Gallbladder Dz

-Complications of Stones

Answer 4

1. Jaundice
   - Bilirubin increased from obstruction
2. Enlarged Liver
   - ALT, AST

Question 5

Gallbladder Dz

-Non-Invasive Treatment

Answer 5

1. Break up the stone with lithotripsy

1. Ursodiol - removes cholesterol from gallstones

Question 6

Gallbladder Dz

-T Tube Expectations

Answer 6

1. > 600 ml’s of drainage for 1st 24 hours

- If more than 500 ml’s after 24 hours call the MD

Question 7

Gallbladder Dz
-T Tube Teaching
(any post surgery teaching)

Answer 7

1. S/S of infection
2. Wound care
3. Diet (Most Pt’s are obese w/ Gallbladder problems)
   - Low fat, low cholesterol, Healthy carbs-Whole grains

Question 8

Gallbladder Dz

• Post Op Complications
• Oxygenation

Answer 8

1. Pneumonia & Atelectasis

- Pain would hinder pt from taking deep breaths

Question 9

Gallbladder Dz

• Post Op Complications
• Nursing Interventions

Answer 9

1. Incentive spirometry
2. Deep breath and cough
   - Splint with a pillow
3. Early ambulation

Question 10

Gallbladder Dz

• Post Op Complications
• Perfusion

Answer 10

1. Shock
2. Hemorrhage
3. DVT
4. Pulmonary Embolism

Question 11

Gallbladder Dz

• Post Op Complications
• Elimination

Answer 11

1. Constipation
2. Altered bowel
   - listen for bowel sounds before feeding
3. Urinary retention

Question 12

Gallbladder Dz

• Post Op Complications
• Pain

Answer 12

1. If pain meds are not working Call MD
   - Add Rx for breakthrough pain
2. Check Pt’s Pain scale 30 minutes after IV morphine administration

Question 13

Gallbladder Dz

-Teaching

Answer 13

1. Diet
   - Low Carb / Low Fat
2. Exercise