Gallbladder is a green pear-shaped muscular saclike organ measuring 7.5 to 10cm long. It is located inferiorly to the right lobe of liver as well as superiorly to the pancreas and duodenum. The main function of the gallbladder is to store a small amount of bile and release it into small intestine. Bile is produced in liver by hepatic cells, which contains cholesterol, bile salts, body salts and bilirubin. Gallbladder concentrates bile by absorbing water and salts. Bile then release into the cystic duct and moves down to the common bile duct in order to enter the duodenum. Cholecystitis can be defined as acute or chronic inflammation of the gallbladder. Cholecystitis can be calculous or acalculous. Most common cause of acute cholecystitis …show more content…
However, patient needs to have gallbladder removed. Patient with cholecystitis requires hospital admission for complete bowel rest and other treatment. NG tube insertion and gastric decompression is other non-pharmacological way to prevent further gall bladder stimulation. Surgical treatment of cholecystitis includes laparoscopic choleycystectomy, percutaneous cholecystectomy and open cholecystectomy .The treatment of choice for symptomatic cholecystitis is laparoscopic choleycystectomy. Approximately 90% of gallbladder removal is done laparoscopically because it is considered as gold standard treatment. This procedure is performed by using four small incisions and gallbladder is removed by using one of them. Likewise, Percutaneous cholecystectomy is other treatment option for diagnosis and treatment of acute cholecystitis for patients who are at risk for any surgical procedure or general anesthesia. Open cholecystectomy is performed when the inflammation is severe. In this procedure gallbladder is surgically opened and the purulent drainage, bile and stones are removed. Cochrane reviews suggest that there is no difference in complication rate, mortality or operative time in comparison to laparoscopic and open cholecystectomy (Graham, 2008). However, because of less surgical risk, less hospital stay and short recovery period current usual treatment option is …show more content…
Evidence shows that patients and carers involvement in discharge planning process maximised patient engagement throughout the treatment process and improves understanding regarding expectations (White, 2014). Nurses play a vital role in educating patients about health condition and management techniques. Evidence suggests that nurses must be experienced and should have ability to assess and make critical decision regarding the discharge process (White, 2014). In this case, Maree has undergone through laparoscopic cholecystectomy and she is going to discharge from hospital after one day of surgery. During discharge time nurse should instruct Maree about the importance of taking medications that are prescribed and actions of medications. Nurse should provide instruction to Maree and family regarding observation that may indicate obstruction such as jaundice, changes in stool and urine colour and pruritus. In addition, instruct patient about signs and symptoms that should be reported such as redness, swelling, bile coloured drainage or pus from incision site and any other signs of infection or inflammation. Nurse should explain that normal activities could be resumed gradually. In this case, Maree continued to refuse moving around and to take deep breaths. Therefore it is important to explain her about the importance of light exercise (walking), which can be done immediately but heavy
The gallbladder according to Dorland’s Medical Dictionary is ‘the pear shaped reservoir for the bile on the posteroinferior surface of the liver, between the right and the left quadrate lobe, from its neck the cystic duct projects to join the common bile duct’. The function of the gallbladder in the human body is to solve and concentrate bile, which is produced by the liver and is necessary for proper digestion of fats.
Strasberg SM (2008). "Acute Calculous Cholecystitis". New England Journal of Medicine 358 (26): 2804–2811. doi: 10.1056/NEJMcp0800929. PMID 18579815
The first laparoscopic cholecystectomy (LC) using keyhole approach was done by Professor Mouret of Lyon, France in 1987, when he was completing a gynecologic laparoscopy on a woman also suffering from symptomatic gall stones, he removed it laparoscopically instead of opening up. Dr. Eddie Reddick reported 100 cases of laparoscopic cholecystectomy in 1989. The classical four port technique of LC as described by Reddick became the most widely adopted technique.
One or more gallstones erode into the gastrointestinal tract, creating a cholecystenteric fistula, most commonly between the gallbladder and the duodenum. Gallstones less than 2 to 2.5 cm generally pass into the intestine without causing obstruction while stones 5 cm or larger are more likely to impact usually at the distal ileum, the narrowest part of the small bowel. Other reported sites of impaction include proximal ileum, jejunem, colon, and rarely the duodenum or stomach (bouveret’s syndrome). [11] In our case, a large, approximately 5 cm, gallstone was found impacted at the jejunum while a smaller stone was found impacted at a Meckel’s
Discharge planning and education has been one of the most important component of patients education provided y nurses and other health care providers. According to Bastable (2008) patient education is the process of assisting people to learn health related behavior that can be incorporated into everyday life with the goal of optimal health and independent in health care. She also mentioned that key to learning and changing is the individual cognition, perception, thoughts, memory, and ways of processing and structuring information. The purpose of this discussion is to provide a home discharge planning for Tina Jones on wound care, diabetes and asthma management (Bastable, Susan Bacorn, 2008).
At the multidisciplinary meeting, the nurse will collect and assess the information provided by the other disciplines and family members stating that the patient is not at her prior level of functioning and then analyze the information to develop a diagnosis of deconditioning. Next, the nurse identifies outcomes for the patient to get stronger, achieve prior level of function, have activities of daily living (ADL’s) met in a safe environment by planning for home health, equipment, and 24/7 supervision through family or placement in a facility. This will be implemented by coordinating delivery of a walker and a 3 in 1 chair prior to discharge to daughter’s home with the home health agency nurse, physical therapist, and aide scheduled to start that day. In a week, the nurse evaluates that outcomes are being met by following up with patient, daughter, and home health agency evaluating that the patient is getting stronger, ADL’s are being met, and will soon be able to return to living independently. To achieve these standards of practice, every nurse should be aware of her own nurse practice act to ensure to be functioning with in the laws of the nurse’s state and to ensure the best outcomes and safety of the patients. In closing, it is every nurses duty to be the best nurse they are capable of being by looking at the scope of nursing practice which gives us the framework to achieve
Nurses help patients with their physical needs with details, explain the complex steps of medical treatment, communicate with doctors to share patients’ health conditions and proper treatments, and give emotional support to patients in stressful situations. There are certain limitations that nurses have in decision makings because doctors obtain the most power in patients’ medical clinics. However, nurses are more friendly, helpful, and suffering for patients. Lastly, experienced nurses can make a better choice for the patients over young and un-experience
The gallbladder is part of the digestive system, which is where gallstones are formed. It is located right under the liver and attached by the hepatic ducts, through which the bile is lead to the gallbladder. As part of the digestive system the gallbladders jobs is to store bile that the liver yields. As the stomach releases its contents into the small intestine, the gallbladder then releases bile that helps with digestion into the bile duct. If bile has too much salts or bilirubin, it can harden and create gallstone ranging sizes at one to three millimeters. Being that the pancreas is also connected through the bile duct, when a gallstone comes into place it can cause pancreatitis.
The pancreas is a large gland that is located in the upper abdomen that secretes digestive juices, and releases insulin and glucagon into the bloodstream. Pancreatitis is a medical term for inflammation of the pancreas. When the pancreas is inflamed, it can progress to swelling of the gland, and surrounding blood vessels, bleeding, infection, and damage to the gland. It occurs when digestives enzymes start digesting the pancreas itself. Pancreatitis has two types; acute or chronic and either type can be life-threatening and have some serious complications.
Digestive disease is common these days and 80% of what people speak about is about who got the disease and how he got it and what kind of disease. So today I will till about the disease called gallstones. Gallstones is a small, hard crystalline mass formed abnormally in the gallbladder or bile ducts from bile pigments, cholesterol, and calcium salts. Gallstones can cause severe pain and blockage of the bile duct. So I will tell you the signs and symptoms of gallstones, causes, people at risk, and treatment of gallstones.
The goal for nurses as a profession is not only to be “patient advocates” but also assist the patient to learn and gain the necessary skills to achieve the best level of functioning for the patient based on their current illness. In order to help a patient achieve their optimal level of functioning the nurse must work with the patient and the interdisciplinary team to create a collaborative plan that is logical for the patient. Through examining a musculoskeletal disorder case study #35 from Preusser (2008), one can create a critical pathway for the patient, S.P. a 75 year old female, with severe rheumatoid arthritis (RA) and admitted to the orthopedic ward for a hip fracture status post fall (p. 183). Since the patient’s needs is unique and complex the nurse must tailor a plan with the patient which will include “…assessments, consultations, treatments, lifestyle changes, disease education…” in order for the patient have the most appropriate evidence-based care and make informed decisions when it is necessary (Oliver, 2006, p. 28). The aim for the nurse caring for the S.P. is to help prepare the patient for an upcoming procedure and focus care to the patient by gathering necessary information about her while. Collaboration with the patient, family members, rehabilitation, medical and surgical team about the treatment plans can help us provide proper patient’s care by utilizing actions and interventions within the scope and standards of the nursing practice.
This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has learning disabilities it was imperative to identify any barriers with communication (Nursing standards 2006).
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
...treatment, surgery may be required, commonly in cases of intestinal hemorrhage. In very rare cases, where the antibiotics do not eradicate the disease, surgical removal of the gallbladder may be required. Although rare, the Cholecystectomy may not always be effective in eradicating the disease, due to it’s persisting hepatic infection state.
Duodenal ulcers are the most common, occurring on the inside of the upper portion of the small intestine called the duodenum. This results when the acid chyme, a semifluid mass of partially digested food, is expelled by the stomach into the duodenum. This chime is not completely neutralized when entering through the pyloric sphincter, thus producing erosions a...