Nursing 212

Health Differences Across the Lifespan 2 Study Guide Teaching: reinforce disease process and gallstone formation; review diagnostic procedures and expected outcomes; diet restriction for patient is to limit high fat foods Cholecystitis Cholecystitis is acute or chronic inflammation of the gallbladder, most commonly associated with cholelithiasis. The pain is similar to that of gall stones. Signs and symptoms include episodic colicky pain in the epigastric area, which radiates to back and shoulder. Jaundice (causes itching-pruritus), clay-colored stools, dark amber urine, steatorrhea, flatulence, indigestion or chest pain after eating fatty or fried foods are also symptoms. Cholecystitis occurs most often in fat, fertile, females over the age of forty (known as the 4 F’s). Causes of cholecystitis include cholelithiasis, estrogen therapy, infection of the gallbladder, and obesity. Interventions: NPO with IV fluids for hydration until pain subsides; opioid analgesics (Morphine) are used for pain control; IV antibiotics are administered; surgery is postponed until acute infectious process has subsided 4.2 Metabolic Disorders in Response to Toxic Substances Cirrhosis The most common cause of cirrhosis is alcoholism. It is a chronic hepatic disease characterized by diffusing destruction of hepatic cells, which are replaced by fibrous cells impairing blood and lymph flow. Cirrhosis is irreversible. There is a decreased absorption and utilization of fat soluble vitamins (A, D, E, and K) with increased aldosterone. Cirrhosis results in ineffective detox of protein wastes. Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue, and regenerative nodules (lumps that occur as a result of a process in which damaged tissue is regenerated). It leads to a loss of liver function. Cirrhosis is most commonly caused by alcoholism, hepatitis B and C, and fatty liver disease, but has many other possible causes. Some cases are idiopathic (of unknowncause). Ascites (fluid retention in the abdominal cavity) is the most common complication of cirrhosis and is associated with a poor quality of life, increased risk of infection, and a poor long-term outcome. Other potentially life-threatening complications are hepatic encephalopathy (confusion and coma) and bleeding from esophageal varices. Cirrhosis is generally irreversible and treatment usually focuses on preventing progression and complications. In advanced stages of cirrhosis, the only option is a liver transplant. Some of the following signs and symptoms may occur in the presence of cirrhosis or as a result of the complications of cirrhosis: • Spider angiomata or spider nevi: Vascular lesions consisting of a central arteriole surrounded by many smaller vessels because of an increase in estradiol; these occur in about one third of cases

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