Exam (elaborations)
NSG3850 EXAM 4 QUESTIONS WITH COMPLETE SOLUTIONS
- Course
- NSG 3850
- Institution
- Galen College Of Nursing
NSG3850 EXAM 4 QUESTIONS WITH COMPLETE SOLUTIONS
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NSG3850 EXAM 4 QUESTIONS WITH COMPLETESOLUTIONS
A significant factor that promotes the continued growth of
stones is hypo (slow) motility, or stasis of bile within the
gallbladder.
Incidence R/T age, gender, & variety of medical issues
Chronic Cholelithiasis
Risk factors for chronic cholelithiasis ***
High spinal cord injuries (nerve disconnect)
Patients receiving total parenteral nutrition
Persons who undergo prolonged fasting or rapid weight loss.
Pregnancy
Oral contraceptives
Diabetes mellitus
Used to be women who were fair, fat, and 40....
Obesity, women, rapid weight loss in obese patients
Fasting - crash dieting - >2lbs/week
How are gallstones developed? ****
-Supersaturation of bile with cholesterol (high fat diet)
-Nucleation of crystals (helping to form)
-Hypomotility allowing stone growth (slow churning, sludgy
,formation of bile)
Poor flow of bile
biliary colic
pain in the gallbladder caused by gallstones obstructing bile
flow
CM of chronic cholelithiasis
Pain radiates to the back w/nausea, vomiting, sweating, and
flatus.
Precipitated by a meal lasting 15 minutes to an hour - pain
slowly decreases
Fatty diet, greasy meals, are often last meals
Due to gallstones (90% of the time)
Can be without cholelithiasis
Acute cholecystisis
Obstruction of the cystic ducts
stasis in the gallbladder
cause of acute cholecystitis
Bacterial infection if often secondary to
acute cholecystitis
Major functions of bile
, To aid in the digestion of lipids (fatty meals) in the diet and to
transport waste products (particularly bilirubin),
immunoglobulins (IgA), toxins, and cholesterol into the intestine
for eventual disposal or reabsorption.
How to diagnose gallbladder issues
all imaging
nothing invasive
What is the first choice for diagnosing acute cholecystitis?
Ultrasound
Endoscope - down through duodenum, up common bile duct to
inject die and see if flowing correctly
Endoscopic retrograde cholangiopancreatography (ERCP)
Complications - perforation and hemorrhage
Precipitation of cholesterol from bile occurs at high
concentrations, predisposing to the formation of gallstones. -
This is why if you have a high fat diet, you could be
more prone to gallstones.
Bile is produced by
hepatocytes in the liver
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