A client is diagnosed with acute cholecystitis and asks the nurse about the difference between acute and chronic cholecystitis. Which of the following responses should the nurse provide?

Choice A reason:

Fasting for 12 hours is not required before an abdominal ultrasound. However, the client may be asked to avoid eating fatty or heavy meals before the procedure.

Choice B reason:

Filling the bladder with a gallon of water is unnecessary and not related to an abdominal ultrasound. A full bladder is required for pelvic ultrasounds, not abdominal ultrasounds.

Choice C reason:

Avoiding drinking liquids for 2 hours before the ultrasound is not necessary. In fact, a full bladder is preferred for better visualization during an abdominal ultrasound.

Choice D reason:

This statement is correct. To have a full bladder for the ultrasound, the client should drink 16 ounces of water about one hour before the procedure. A full bladder helps lift the intestines and improves the visualization of the gallbladder and surrounding structures.

Choice A reason:

Rebound tenderness in the right upper quadrant is not a hallmark sign of acute cholecystitis. It may be present in conditions such as appendicitis or peritonitis.

Choice B reason:

This statement is correct. Murphy's sign is a hallmark sign of acute cholecystitis. It is elicited by asking the client to take a deep breath while the nurse palpates the right upper quadrant. If the client abruptly stops breathing due to pain upon palpation, it indicates inflammation of the gallbladder (positive Murphy's sign).

Choice C reason:

Hypoactive bowel sounds may be present in some gastrointestinal conditions but are not specific to acute cholecystitis.

Choice D reason:

Left lower quadrant abdominal pain is not associated with acute cholecystitis. This type of pain is more commonly seen in conditions such as diverticulitis or colitis.