A 28 year old female presents to the ER with upper right abdominal pain. She states...

A 28 year old female presents to the ER with upper right abdominal pain. She states her pain begins around abdomen and radiates to her right breast bone and upper back. She presents with nausea and vomiting x3 episodes, abdominal bloating, and flatulence. Her V/S are: TEMP 101.4°F, PR 92, BP 138/72, RR 20, O2 99% at room air. Patient is 5’3” and 181 lbs. with BMI of 32. Patient medical history: appendicitis with appendectomy 5/27/2020. MD wants to have lab work and diagnostic tools to determine if she is having cholelithiasis.

What lab work and/or diagnostic tests do you anticipate will be ordered to diagnose cholelithiasis?

What information is missing regarding head to toe assessment that you as the nurse should monitor and/or assess?

What lab work and/or diagnostic tests do you anticipate will be ordered to diagnose cholelithiasis?

What information is missing regarding head to toe assessment that you as the nurse should monitor and/or assess?

Solutions

Expert Solution

Answer =

Cholelithiasis = A stone formatioon in the gallbladder is called cholelithiasis .

- Cholesterol saturated bile predisposes to the formation of gallstones and acts as an irritant, producing inflammatory changes in the gallbladder.

- Cholesterol stones are the most common type of gallstones.

- Stone formation increases in users of contraceptives, estrogen and cholesterollowering drugs,and intake of high amount cholesterol through food.

Diagnostic evaluation =

- Oral cholecystography, Ultrasonography, and HIDA scan may show stones or inflammation .

- ERCP or PTC to visualize location of stones and extent of obstruction.

- Elevated conjugated bilirubin and alkaline phosphatase because of obstruction.

Nursing assessment =

- Assess patient pain for location, discription, intensity, relieving and exacerbating factors.

- Assess the sign of dehydration - dry mucus membranes poor skin turgor, low urine specific gravity.

- Assess sclera and skin for jaundice .

- Monitor temperature and WBC count for indicatons of infection.

Nightingale answered 1 year ago

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