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Clinical Manifestation and Symptoms

- Many people with cholelithiasis are asymptomatic and do not experience any signs or symptoms. However, when a gallstone blocks the flow of bile from the gallbladder or the bile ducts, it can cause acute or chronic inflammation and infection of the gallbladder (cholecystitis) or the bile ducts (cholangitis).

- This can lead to the following signs and symptoms:

  • Biliary colic: a sudden and severe pain in the upper right abdomen or epigastrium that may radiate to the back, shoulder, or chest. The pain usually occurs after a fatty meal and lasts for 15 minutes to several hours. It may be associated with nausea, vomiting, sweating, or restlessness.
  • Jaundice: a yellowing of the skin and eyes due to elevated levels of bilirubin in the blood. It may also cause dark urine, pale stools, itching, or malaise.
  • Fever and chills: a sign of infection or inflammation of the gallbladder or the bile ducts. It may also be accompanied by leukocytosis, increased liver enzymes, or increased bilirubin levels.
  • Murphy's sign: a positive physical examination finding in which there is pain or cessation of breathing when the examiner palpates the right upper quadrant of the abdomen during inspiration.

Questions on Clinical Manifestation and Symptoms

Correct Answer is C

Explanation

Encouraging the client to rest is important, but it is not the priority action in managing the client's severe pain and other symptoms.

Correct Answer is B

Explanation

Discussing the possibility of experiencing diarrhea after the surgery is not a priority in preoperative education for a client with cholelithiasis undergoing cholecystectomy.

Correct Answer is B

Explanation

Placing a heating pad on the client's abdomen may provide temporary relief for discomfort but is not appropriate when the client has a fever and suspected infection.

Correct Answer is A

Explanation

Muscle weakness and fatigue are not common adverse effects of UDCA.

Correct Answer is A

Explanation

Drinking sugary beverages is not recommended for preventing gallstones. It is essential to maintain hydration, but sugary beverages can contribute to obesity and other health problems, increasing the risk of cholelithiasis.

Correct Answer is A

Explanation

Undergoing bariatric surgery for weight loss may affect the risk of developing gallstones, but it is not the highest risk factor among the options provided.

Correct Answer is C

Explanation

Hormones do not weaken the gallbladder wall, and this is not a direct mechanism for gallstone accumulation.

Correct Answer is C

Explanation

High consumption of lean protein and low-fat dairy products may be part of a healthy diet, but they are not the primary risk factor for cholelithiasis.

Correct Answer is A

Explanation

This statement is incorrect. Rapid weight loss, especially with a low-fat diet, can contribute to gallstone formation due to changes in bile composition and gallbladder function.

Correct Answer is D

Explanation

This statement is correct. Hormonal contraceptives, especially those containing estrogen, are associated with an increased risk of gallstone formation due to their impact on cholesterol metabolism in the gallbladder.

Correct Answer is A

Explanation

Steady pain may not adequately describe the intermittent nature of the pain experienced by the client.

Correct Answer is C

Explanation

Steatorrhea refers to the presence of excess fat in the feces and is not related to the client's symptoms.

Correct Answer is C

Explanation

Ascites refers to the accumulation of fluid in the abdominal cavity and is not related to the client's symptom.

Correct Answer is C

Explanation

Hyperalgesia refers to an increased sensitivity to pain and is not related to the client's symptom.

Correct Answer is A

Explanation

Petechiae refers to small, pinpoint-sized red or purple spots on the skin caused by bleeding and is not related to the client's symptom.

Correct Answer is B

Explanation

Evaluating kidney function is not the primary purpose of an abdominal ultrasound for a client with suspected cholelithiasis.

Correct Answer is C

Explanation

While there may be no specific dietary restrictions, eating a low-fat meal is often recommended to facilitate the evaluation of cholelithiasis during the ultrasound.

Correct Answer is C

Explanation

Low serum amylase levels are not specific to cholelithiasis or its complications.

Correct Answer is B

Explanation

A radioactive tracer injection is used in hepatobiliary iminodiacetic acid (HIDA) scan, not an oral cholecystogram.

This statement is correct. PTC is a diagnostic imaging procedure that involves injecting contrast dye into the biliary tree to visualize the bile ducts and identify any obstructions, such as gallstones, which could be causing cholelithiasis.

<p>This statement is correct. Reporting any signs of infection or bleeding at the incision site is crucial for the early detection and management of potential complications after surgery.</p>

<p>Diphenhydramine is an antihistamine and is not used for pain relief in cases of biliary colic.</p>

Providing a high-fat meal before the procedure is not recommended, as clients should maintain NPO status before ERCP.

Continuing on a clear liquid diet for a few more days is not appropriate for a client who has already undergone cholecystectomy and has advanced past the initial post-operative phase.

Ursodeoxycholic acid is not typically used for pain relief during gallstone attacks. It is used for long-term management to dissolve gallstones and reduce the need for surgical intervention.

Position changes and deep breathing exercises may be helpful in some situations, but they are unlikely to provide sufficient relief for severe pain due to gallstone obstruction.

This statement is correct. The nurse should provide the client with detailed information about the cholecystectomy procedure, its benefits, potential risks, and complications. This information can help the client make informed decisions and alleviate anxiety.

Instructing the client to perform deep breathing exercises is important for postoperative recovery, but it does not address the immediate need for pain management.

Avoiding physical activity for six weeks is not typically required after a cholecystectomy. Gradual activity resumption is recommended earlier than that.

While fatty foods can lead to digestive problems for some individuals, the primary concern in a client post-cholecystectomy is gallstone prevention and liver support.

Limiting physical activity is not a preventive strategy for gallstone formation. Regular physical activity is beneficial for overall health, including gallbladder function.

Limiting fluid intake can lead to dehydration and increase the risk of gallstone formation. Adequate hydration is essential for gallbladder health.

This statement is correct. Engaging in regular exercise is an important preventive measure for gallstone formation and overall gallbladder health.

Increasing alcohol intake is not a preventive measure for gallstones and may actually contribute to gallstone formation.

Consuming large portions of dairy products is not a specific preventive measure for gallstones. A balanced diet with limited fat intake is recommended.

Valerian Root is not typically used for gallstone prevention. It is primarily known for its sedative properties and may not have any direct impact on gallbladder health.

Lithotripsy is not a diagnostic test. It is a therapeutic procedure to treat gallstones.

While discussing potential complications of general anesthesia is essential for preoperative education, it may not be the primary concern for a client recovering from cholecystectomy.
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