cholelithiasis

this case presentation explains about cholelethiasis

1. CHOLELITHIASIS PRESENTED BY :- MR. JUBER DONUR (ASST. LECTURE) BANGI INSTITUTE OF NURSING SCIENCES VIJAYAPURA .

2. 6. a) Define cholelithiasis.  b) Describe the pathophysiology and enlist clinical Manifestation . c) explain the pre and post operative nursing management of Mrs. X who is suffering from cholelithiasis.

3. A) INTRODUCTION Located below the liver Pouch like structure Secretion of bile by liver Will stores and episodically Enters into small intestine Which help for digestion of Fat.

4. DEFINITION Condition in which formation of stones into gall bladder called CHOLELITHIASIS Choledocholithiasis :- condition in which stone forms into common bile duct of the bladder called choledolchoithoasis .

5. CLASSIFICATION Choestrol cholelithiasis (yellow coloured stone) Pigment cholelithiasis (bile cholelithiasis)- dark brown/ black colour Mixed cholelithiasis – both stones

6. CAUSES Ediopathic Female Fat Fourty age Genetic High fat diet Cirhosis of liver Gall bladder inflammation Increases level of bilurubin - calcuim salats

7. B) PATHOPHYSIOLOGY Due to aetiology—> cholesterol level suprificstion —> hypomobility (decreased function of gall bladder)—> Cholesterol nuclification ( liqid cholestrolconverts into crystal)—> accreation (hyper secreation of mucus that makes stone solid) —> sign and symptoms of gallstones

8. CLINICAL MANIFESTATION Upper right abdominal pain Pain after fat meal Nausea and vomiting Clay coloured stool Dark coloured urine Burping (gas come out through mouth) Diarrhoea Dehydration. Increased thirst Indigestion Malnutrition Weakness

9. DIAGNOSTIC EVALUATION HISTORY TAKING PHYSICAL EXAMINATION X-ray CT MRI Blood test (increased bilirubin)

10. MEDICAL MANAGEMENT Medications are not most commonly used. Antibiotics Analgesics Anti diarrhoeal Anti emetics Anat acids, H2 blocker, PPI ACTIGALL ( dissolved the stone and should take for longer time)

11. C) SURGICAL MANAGEMENT Shock wave lithiotripsy Laproscopic cholecystectomy

12. NURSING DIAGNOSIS Acute pain related to obstruction and inflammation. Risk for deficit volume related to diarrhoea and vomiting. Risk for imbalanced nutrition related to nausea and vomiting Deficit knowledge related to disease condition Fear and anxiety related to hospitalisation.

13. Pre and post operative care PRE OPERATIVE CARE Plan for OT Written consent from pt Explain procedures Check vitals Prepare for anaesthesia. Empty the bladder before surgery Shave the area POST OPERATIVE CARE Assess consciousness Vital sings Assess incisions Provide adequate fluid Health education