Cholelithiasis/Cholecystitis
The nurse is completing patient education for a patient to be discharged after undergoing an open cholecystectomy. Which statement by the patient indicates effective teaching by the nurse?
"I should not be carrying the laundry baskets upstairs."
The nursing instructor asks the student nurse caring for a patient who has undergone open cholecystectomy with placement of a T tube to explain the reason for placement of the T tube. Which statement by the student indicates accurate understanding?
"The T tube ensures patency of the bile duct and allows excess bile to drain until edema decreases."
The nurse is caring for a patient with cholecystitis. The patient is concerned and wants to know why the pain is worse after eating a cheeseburger brought in by the family. What is the nurse's best response?
"This is common. Pain tends to worsen a few hours after a high-fat meal."
What would be the best collaborative care intervention for a patient admitted for treatment of an acute episode of cholecystitis who reports dry skin and severe itching?
Administer cholestyramine
The nurse is preparing to administer an injection to a patient being treated for obstructive choledocholithiasis. The patient has been having severe episodes of nausea and vomiting and has a temperature of 100.2° F and bleeding gums. Which actions taken by the nurse will reduce potential complications from the injection? Select all.
Apply gentle pressure to the injection site Choose a 23-gauge needle
A 55-year-old obese African American woman has been admitted for a cholecystectomy to treat cholecystitis. The patient asks the nurse what factors might have predisposed her to cholecystitis. Which factors would the nurse mention?
Being female Being overweight Over the age of 40
The nurse is caring for a patient who is returning from the endoscopy lab after undergoing an endoscopic retrograde cholangiopancreatography (ERCP). What should the nurse assess before the patient resumes eating?
Gag reflex
Which statement made by the student nurse when caring for a patient who has had an open cholecystectomy requires correction?
I will teach the patient to resume normal activities in two weeks
Which nursing interventions will be most effective to alleviate nausea and vomiting by decreasing gallbladder stimulation in a patient with cholecystitis? Select all.
Insert NG tube Establish NPO status
A female patient scheduled for a laparoscopic cholecystectomy tells the nurse she is frightened because she has heard from others that the abdominal distention and pain after the surgery are severe. Which care team recommendation will best help alleviate distention?
We will help you walk in the hall to decrease distention
The nurse is caring for a patient receiving nonoperative treatment for cholelithiasis. The nurse enters the patient's room, and the family asks how the patient will be kept comfortable, since surgery is not an option. Which nursing interventions will address the family's concerns? Select all.
Administer opioid analgesics Provide the patient with a low-fat diet
The nurse is teaching a patient being treated for cholecystitis about the anticholinergic medication that has just been prescribed. Which information provided by the nurse accurately describes the use of this medication for cholecystitis?
"This medication will decrease gastrointestinal (GI) secretions and reduce gallbladder spasms."
During assessment of a patient for suspected cholelithiasis with biliary colic, a positive response to which question posed by the nurse would support the diagnosis?
Do you have pain after consuming a high-fat meal
A patient who has undergone laparoscopic cholecystectomy asks the nurse about getting up and taking a shower. Which response by the nurse would be appropriate?
It is best to do a bedside bath because you want to keep the dressing dry
The nurse is reviewing the laboratory reports of four patients in a general medical-surgical unit. Based on the laboratory data, which patient is most likely to have cholelithiasis/cholecystitis?
Patient 1 (WBC 12.0)
A patient in the recovery room after laparoscopic cholecystectomy reports severe bloating and abdominal discomfort. Which nursing intervention would best address this patient's concern?
Place the patient in the Sims' position
A patient presents to the emergency department and reports frequent small light-colored stools and fever. On examination, the nurse notes jaundice of the skin and sclera and a white blood cell (WBC) count of 15,000 /μL. An ultrasound examination indicates the patient has a dilated common bile duct with gallstones. What is the priority nursing intervention for this patient?
Prepare the patient for an endoscopic retrograde cholangiopancreatography (ERCP)
A patient who is not a candidate for surgery is admitted to the hospital with acute cholecystitis and severe nausea and vomiting. Which collaborative care intervention will help maintain fluid and electrolyte balances?
Start an IV infusion of LR
The nurse is assessing a patient who has arrived in the emergency department complaining of severe upper abdominal pain after eating a cinnamon roll. The nurse notes yellowing of the sclera and skin and dark amber-colored urine. What does the nurse suspect has occurred?
The patient has developed an obstruction in the common bile duct by a gallstone.