Cholecystitis and Perioperative Care
Cholecystitis is the inflammation of the gallbladder. The gallbladder is a small pear-
shaped sac located on the right underside of the liver. The gallbladder’s function is to store digestive bile, which is continuously produced by the liver. Bile assists in the digestion of fats and absorption of certain vitamins.
A healthy gallbladder empties when fatty foods enter the duodenum to aid in breaking down large fat particles into smaller ones. In most cases, cholecystitis is caused by a blockage or a stone in the gallbladder. “About 90 % of cholecystitis is caused by gallstones, often found blocking the cystic duct” (Baldwin 2008). Bile becomes trapped in the gallbladder and causes pressure and irritation.
Gallstones are mostly composed of cholesterol. Solid lumps develop when the bile that is stored crystallizes. Other gallbladder stones can be composed of calcium salts or bilirubin, the end product of red blood cell destruction.
Research indicates that gallstone disease is the most common abdominal reason for hospital admission. Risk factors that are known to increase gallstone formation include: being female, rapid weight-loss and fasting, diabetes and certain medications. Medications such as oral contraceptives and cholesterol-lowering drugs. It is imperative that “nurses have a great understanding of cholecystitis and the surgical procedure, to ensure that patients are cared for not only empathetically but also safely and effectively” (Graham 2008).
The signs and symptoms of acute cholecystitis include sudden onset pain and tenderness in the right upper quadrant of the abdomen. This pain can radiate to the right shoulder and...
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...be provided practical discharge instruction and information about pain management, wound care, returning to daily activities and following up with their primary-care physician.
This paper has focused on patient care after treatment for cholecystitis. As a nurse working in a medical-surgical unit, effective perioperative assessment and well-managed postoperative care can contribute to a successful outcome for the patient.
Works Cited
Baldwin, S. (2008). Gallbladder disease: imaging and treatment. Radiologic Technology, 80(2), 131.
Graham, L. (2008). Care of patients undergoing laparoscopic cholecystectomy. Nursing Standard, 23(7), 41-48.
What to do about gallstones. (2011). Harvard Women's Health Watch, 18(7), 6-7.
Gaby, A. (2009). Nutritional approaches to prevention and treatment of gallstones. Alternative Medicine Review, 14(3), 258-267.
Gallstones form when the liquid stored in the gallbladder hardens into pieces of stone-like material. The liquid, called bile is used to help the body digest fats. Bile is made in the liver, and then stored in the gallbladder until the body needs to digest fat. At that time, the gallbladder contracts and pushes the bile into a tube—called the common bile duct—that carries it to the small intestine, where it help with digestion.
Strasberg SM (2008). "Acute Calculous Cholecystitis". New England Journal of Medicine 358 (26): 2804–2811. doi: 10.1056/NEJMcp0800929. PMID 18579815
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).
Assisting the patient with the five basic activities of daily living bathing, dressing, toileting, eating, and transferring and mobility using aids when needed. Maintaining the client’s personal hygiene and emotional well-being monitoring patient for any signs of exertion. Providing the patient with self-management of medications. Providing the patient with educational materials on their current condition and how to administer their medication (Humphreys, 2011).
According the National Transitions of Care Coalition (2008), improving communication in transitions of care, implementing standardized electronic medical records, establishing points of accountability for sending and receiving care, and expanding roles of pharmacists in transitions of care all aid in the continuity of care and result in positive patient outcomes. However, often the expectations of transitions of care fall short because team members are unsure of their role and the information that should be relayed. The patient’s risk for harm may have been increased when she was discharged
Although, kidney stones cannot be tied to a specific cause like what is eaten, certain factors increase the porosity to kidney stones. Some of the factors is overweight, a history of kidney problem, individuals that drink a lot of fluid. Below is how some kidney stones looks like pertaining to the shapes and size.
Discharge planning nurses achieve this move through the collection and organisation of patient data from various health professionals who treated the patient prior to and during the hospital stay. This data is used to establish the patient’s ‘baseline’ or personal average health level, and which services are needed after discharge to return the patient to this level (Holand, 2016). This could be a transition into a nursing home or rehabilitation facility, the establishment of home nursing or carer services or physiotherapy, social work, dietetics and occupational therapy professionals through
When a patient is unable to make care decisions for themselves, it is necessary to involve those closest to them, most often family members. Providing a supporting environment to family members is another way that the best interest of the patient can be maintained. Families and friends can make a huge difference in the life of the patient after discharge. Instructing families in a way that is easy to understand helps eliminate potential barriers to communication. Families should be aware of what things to look for, what would constitute an emergency, and how to safely handle
Spivak, W.K., & deSouza, J.M. (2008). Diverticulitis of the right colon. Digestive diseases and sciences. 49: 350-358
According to agency of health care research and quality it is estimated that almost one third of health care spending is due to inpatient surgical procedures and it also estimates that average hospital costs has been increased from $ 9,100 in 2003 to $11,000 in 2013. [4] Some major reasons for this increase in costs includes lack of coordination, risk associated with complicated surgical procedures, poor patient engagement in decision making, quality requirements and etc. The perioperative surgical homes are very effective in solving these problems and achieve better surgical outcomes as it is a coordinated care which is led by multi specialty physicians who provides continuum of care to patients from the time of decision to 30 days after discharge of the patient i.e., it is incorporated in to include all three phases of surgery; perioperative, intra-operative and postoperative
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
Alcohol abuse and gallstones are the two main causes of pancreatitis, accounting for 80% to 90% of all individuals diagnosed with the condition.
communicating in a professional manner in order to provide the best standard of care for the
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.