NUR336 Evolve: Gallbladder Disorders Quiz
The nurse is teaching a female patient about cholecystectomy via a natural orifice transluminal endoscopic surgery (NOTES). What statement by the patient indicates that the teaching has been effective?
"A small incision will be made in my vagina to access my gallbladder."
The nurse is teaching a patient receiving chenodiol acid for cholelithiasis. What statement by the patient indicates a need for further teaching?
"I should take the medication on an empty stomach."
A patient receiving ursodeoxycholic acid for cholelithiasis has just received teaching about the medication. What statement by the patient indicates the teaching was effective?
"I will need to have gallbladder ultrasound every 6 months for a year."
The nurse is teaching a patient about extracorporeal shockwave lithotripsy. What statement by the patient indicates a need for further teaching?
"I will sit in 12 inches of water."
A patient receiving chenodiol acid for cholelithiasis has just received teaching about the medication. What statement by the patient indicates that the teaching was effective?
"If I have diarrhea, I will call my doctor."
The nurse is providing postoperative teaching to a patient scheduled for a laparoscopic cholecystectomy. What instructions should be included?
"Introduce high-fat foods one at a time."
A patient who underwent a traditional cholecystectomy is concerned that the drainage in the Jackson-Pratt drain is now green. What statement by the nurse is most appropriate?
"It is normal for the first 24 hours."
A patient has developed acute pancreatitis after also developing gallstones. Which is the highest priority instruction for this patient to avoid further attacks of pancreatitis?
"See your health care provider immediately when experiencing symptoms of a gallbladder attack."
A patient diagnosed with acalculous cholecystitis asks the nurse how the gallbladder inflammation developed when there is no history of gallstones. What is the nurse's best response?
"This type of gallbladder inflammation is associated with hypovolemia."
What patient has the highest risk for development of cholecystitis?
55-year-old American Indiana female with Crohn's disease.
A patient who has undergone an open cholecystectomy reports mild to moderate nausea. Which nursing action is correct?
Administer an antiemetic as prescribed as soon as possible.
A patient who has undergone a laparoscopic cholecystectomy is complaining of upper chest and shoulder pain. What action by the nurse is most appropriate?
Administer heat.
A patient suspected of having cholecystitis presents with severe upper epigastric pain radiating to the right shoulder. The patient is vomiting and has abdominal distention. What findings do these symptoms indicate?
Biliary colic.
A patient admitted for cholecystitis who is scheduled for a cholecystectomy in 6 hours reports pain of 3/10 and requests pain medication. Vital signs are blood pressure 120/68, pulse 86, and temperature of 98.9° F. What medication does the nurse anticipate administering?
Cholecystitis is inflammation of the gallbladder. Cholecystectomy is surgical removal of the gallbladder. Ketorolac IV. Ketorolac IV is given for mild pain related to cholecystitis. Morphine is for more severe pain. PO meds not given because patient is scheduled for surgery.
A patient reports fever, yellowing of the skin and eyes, clay-colored stools, and dark urine to the nurse. What do these symptoms indicate?
Chronic cholecystitis.
A patient with cholecystitis has jaundice and icterus. These signs are typical of which type of cholecystitis?
Chronic.
The nurse is preparing a patient for a laparoscopic cholecystectomy. After reinforcing the surgeon's preoperative teaching, what does the nurse instruct the patient about next?
Discuss postoperative pain medications, deep-breathing, and leg exercises.
A patient who has undergone a laparoscopic cholecystectomy reports mild postoperative abdominal bloating and discomfort. Which nursing action is correct?
Encourage the patient to ambulate in the hall.
Which drug is often used as a contrast medium in a magnetic resonance imaging (MRI) scan?
Gadolinium.
Which diagnostic results lead the nurse to suspect that a patient may have gallbladder disease?
Increased white blood cell (WBC) count, visualization of calcified gallstones, edema of the gallbladder wall.
A patient scheduled for a cholecystectomy because of gallstones causing cholecystitis reports a pain level of 4 on a 0-to-10 pain scale. Which analgesic medication does the nurse anticipate will be prescribed for the patient?
Ketorolac.
A patient is undergoing extracorporeal shockwave lithotripsy. The patient complains of pain in the abdomen. What action by the nurse is appropriate?
Let the patient know this is normal when the stones are breaking up and moving.
A patient with cholecystitis reports pain in the right upper abdominal quadrant after a meal. The nurse assesses the patient and notes a heart rate of 98 beats/min, pallor, and diaphoresis. Which initial nursing action is correct?
Notify the Rapid Response Team.
A patient has an external drain attached to a percutaneous transhepatic biliary catheter. The nurse notes a reduction in bile drainage from the previous amount. Which nursing action is correct?
Notify the provider that the drain is not functioning correctly.
Female patients with which factors are considered to be at high risk for developing cholelithiasis?
Pregnancy.
A patient who has undergone an open cholecystectomy 12 hours prior has a Jackson-Pratt (JP) drain. The nurse empties the drainage and notes bile-stained serosanguineous fluid. Which nursing action is correct?
Record the amount and color of the fluid and continue to monitor the patient.
The nurse is caring for a patient who is 2 hours post open cholecystectomy. What finding would require immediate intervention?
Refusal to cough and deep breathe.
What finding is priority for a patient who has just undergone an open cholecystectomy?
Respiratory rate of 8 breaths/minute.
A patient with an external transhepatic biliary catheter has had a reduction in drainage. What does this finding indicate?
The catheter is not working.
The patient has severe biliary obstruction. What type of surgery does the nurse anticipate this patient requiring in order to explore the ducts for patency?
Traditional cholecystectomy.
A female patient is scheduled for a cholecystectomy by natural orifice transluminal endoscopic surgery (NOTES). Which area is most commonly used for inserting the endoscope during this procedure?
Vagina.
What elevated blood level indicates inflammation in a patient diagnosed with cholecystitis?
White blood cell count.
