Mod 10 Gallbladder disease
The nurse is teaching a client with cholelithiasis about lifestyle modification. Which statement made by the client indicates that the nurse's teaching has been successful? A. "I will walk three times a week for 20 minutes each day." B. "I can fry food as long as I use olive oil instead of vegetable oil." C. "I will use more ground beef in my meal preparation." D. "I will eliminate salt from my diet."
A Obesity is commonly associated with the development of gallbladder disease. A balanced diet and exercise will help keep the client's weight within normal limits. There is no reason to eliminate salt from the diet. Ground beef is high in fat and should be limited. Frying adds additional fat and should be avoided.
A client with cholelithiasis is not a surgical candidate at this time. Which pharmacologic treatment should the nurse expect to be prescribed for this client? (Select all that apply.) A. Antibiotics B. Chenodiol C. Cholestyramine D. Ursodiol E. Antipyretics
A, B, C, D Pharmacologic treatment for gallstones is used for clients who refuse surgery or for whom surgery is contraindicated. Medications used in the treatment of gallstones include ursodiol, chenodiol, antibiotics, cholestyramine, and opioid analgesics. Antipyretics are a pharmacologic treatment for fever, not cholelithiasis itself.
The nurse is preparing health promotion teaching for a client with gallbladder disease. Which topic should the nurse include in the teaching session? (Select all that apply.) A. Role of a high-cholesterol diet on gallstone formation B. Importance of a low-cholesterol diet C. Dangers of rapid weight loss D. Role of hypolipidemia on gallstone formation E. Importance of a high-fiber diet
A, B, C, E Clients should be taught about the role of obesity, hyperlipidemia, and a high-cholesterol diet on gallstone formation; the importance of a high-fiber, low-fat, and low-cholesterol diet to reduce the incidence of gallbladder disorders; and the dangers of rapid weight loss. Hypolipidemia does not promote gallstone formation.
A client asks what causes gallstones to form. Which factor should the nurse explain as being present when these stones are formed? (Select all that apply.) A. Biliary stasis B. Excess cholesterol C. Abnormal bile composition D. Rapid weight gain E. Inflammation of the gallbladder
A, B, C, E Gallstones are formed due to abnormal bile composition, an inflammation of the gallbladder, biliary stasis, and excess cholesterol. Rapid weight loss, not weight gain, is a factor that contributes to the formation of gallstones.
A client scheduled for a cholecystectomy asks what caused the gallstones to develop. Which risk factor should the nurse list when responding to this client? (Select all that apply.) A. Obesity B. American Indian ethnicity C. Family history of gallstones D. Male sex E. Hyperlipidemia
A, B, C, E The risk factors for developing gallbladder disorders include age, family history of gallstones, American Indian ethnicity, obesity, hyperlipidemia, female sex, pregnancy, diabetes mellitus, cirrhosis, ileal disease, and sickle cell disease. Men have a lower risk of developing gallbladder disorders.
A pregnant client of American Indian heritage experiences mild gastric distress and nausea after eating large meals and constant sharp abdominal pain. Which additional information should the nurse collect during the interview? (Select all that apply.) A. Other symptoms B. History of chronic diseases C. Expected due date D. Length of time the symptoms last and when they occur E. Current diet F. Smoking history
A, B, D, E
A client is experiencing pain and nausea related to biliary colic. Which statement should the nurse make to manage this client's symptoms? (Select all that apply.) A. "Medication will help with the nausea and vomiting." B. "It's important for you to be comfortable so that you can rest." C. "A bland diet helps with nausea." D. "Pain medication will be prescribed." E. "Intravenous fluids will ensure that you are well hydrated."
A, B, D, E Clinical therapies for treating biliary colic include administering analgesics, getting adequate rest, correcting fluid and electrolyte imbalances, and administering antiemetics.
A client is experiencing severe upper abdominal pain and jaundice. Which finding on the cholescintigraphy should indicate to the nurse that the client has cholelithiasis? A. Accumulation of bile in the hepatic duct B. Obstruction of the cystic duct by a gallstone C. Accumulation of fat in the wall of the gallbladder D. Viral infection of the gallbladder
B Cholelithiasis is almost always caused by a gallstone lodged in the cystic duct. Accumulation of bile in the hepatic duct would not lead to cholecystitis. Neither the accumulation of fat nor a viral infection leads to cholecystitis.
A client with right upper quadrant abdominal pain asks why so many tests are being scheduled. Which is the reason that the nurse should give to this client? (Select all that apply.) A. To prevent recurrence B. To determine if gallstones are present C. To diagnose the disorder D. To identify possible complications E. To determine the location of gallstones
B, C, D, E Diagnostic tests are used to identify the presence and location of gallstones, identify possible complications of the gallstones, and help differentiate gallbladder disorders from other disease processes. Diagnostic tests do not prevent the formation of gallstones but can give information necessary for treatments that prevent recurrence.
Which is a risk factor for gallbladder disease? A. Hypocalcemia B. Male gender C. Rapid weight loss Your answer is correct. D. Hypolipidemia
C Rapid weight loss, hyperlipidemia (not hypolipidemia), and female (not male) gender are risk factors for gallbladder disease. Hypocalcemia is not a risk factor.
The nurse is planning an educational program about development and prevention of gallstones for a community group. Which population should the nurse identify to be most at risk for developing gallstones? A. Middle-aged Caucasian American men B. Young adult Asian American women C. African American clients D. Women over the age of 40
D Genetic considerations and risk factors vary depending on the nature of the inflammatory disorder. Female sex, being over the age of 40, American Indians, and Mexican Americans are most at risk for gallstones. Family history is also associated with increased risk.
A client with acute cholecystitis is experiencing jaundice. Which should the nurse consider as the reason for the jaundice? A. Accumulation of bile in the hepatic duct B. Accumulation of fat in the wall of the gallbladder C. Viral infection of the gallbladder D. Obstruction of the cystic duct by a gallstone
D When acute cholecystitis is accompanied by jaundice, partial common duct obstruction is likely, which is usually due to stones or inflammation.