ETIOLOGY/ DISEASE MEDICAL SIGNS AND DIAGNOSTIC NURSING EXPECTED NURSING

MANAGEMENT
RISK FACTORS PROCESS DIAGNOSIS SYMPTOMS EXAMS DIAGNOSIS OUTCOMES INTERVENTIONS

PREDISPOSING FACTORS PRECIPITATING FACTORS

 High sodium and fat diet  Cholecystectomy last 2015

Bile in gallbladder become lithogenic

Cholesterol become supersaturated and is

kept in solution by bile acids and lecithin

High levels of deoxycolate occur, which

causes higher cholesterol secretion

Nucleation occurs

Formation of cholesterol crystals Cholelithiasis

 Stone obstructs and inflames surrounding CT Scan Result:
tissue of the common bile duct Multiple choledocolithiases with
intra-extrahepatic bile duct ectasia

Intermittent obstruction
UTZ Result:
Multiple choledocholithiases (CBD
and left main intrahepatic ducts) with
intra and extrahepatic bile duct
dilatation

Choledocolithiasis
Liver is obstructed, which is Stone blocks secretion of Biliary tract cannot transport bile
the site for hematopoiesis pancreatic enzymes to the intestine
Surgical management:
Cholecystectomy
CBC Result: CT Scan Result: Plump pancreas Bile stasis
Hgb = 79
Hct = 0.22
WBC = 29.40
RBC = 2.95 Pancreatitis Bile backs up into liver and
Platelet = 587 injures ductal tissue

Dizziness Pharmacologic
management: Epo
 Ineffective tissue perfusion related to Acute Cholangitis Routine Chemistry Results:
decreased hemoglobin count  Increased direct bilirubin
 Increased total bilirubin
 Increase alkaline
phosphatase
 Assess capillary refill, skin color, Yellow discoloration of skin Fever
mucous membrane and mucous membrane
 Check mental status
 Elevate head of bed
 Provide quiet environment
 Ensure safety by raising side rails Obstructive Jaundice Hyperthermia may be
 Render health teachings such as: related to ongoing process
a) avoid straining b) deep
breathing exercise c) eat foods
rich in iron Risk for Infection Surgical management:
Insertion of PTBD tube  Monitor VS especially
temperature
 Administer prescribed antipyretic
 Report decrease in pain Pharmacologic medication
 Demonstrate use of relaxation management: Pain  Encourage to increase fluid intake
techniques Metronidazole and
Pip Taz

Acute pain related to presence Pharmacologic

of PTBD tube management: Paracetamol

 Assess pain characteristics  Decrease in

 Report decrease in  Assist in re-positioning temperature to
pain  Facilitate DBE within normal
Pharmacologic  Encourage adequate rest range
 Demonstrate use of management: Tramadol
relaxation techniques and sleep