NSG 210 Test 3 Study Guide

Dx thru imaging lab values imaging ercp is the most

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Unformatted text preview: otics: b/c of rx for infection  ­Ursodeoxycholic acid (UDCA) or chenodeoxycholic acid (CDCA) have been used to dissolve small, cholesterol gallstones. These drugs are typically used on pts who refuse surgery or for whom surgery is considered too risky. It takes 6 ­12 months of therapy. Extracorporeal shock wave lithotripsy (ESWL): used for non ­surgical fragmentation of gallstones. It uses repeated shock waves directed at the gallstones to break them up. It is only for small, cholesterol gallstones & pts that are 20 lbs or less over ideal body weight. ESLW is typically used in conjunction w/ UDCA that helps dissolve the remaining fragments post ­ESLW. ERCP: described above under dx. For removal of a gallstone, careful insertion of a catheter through the endoscope into the common bile duct is the most important step. It is particularly useful in tx of pts who have s/s after biliary tract surgery, pts w/ intact gallbladders & pts for whom surgery is considered too risky. Percutaneous trans ­hepatic biliary catheter: only for temporary relief and usually only used on pts not ideal candidates for surgery. Involves the use of internal/external drains that are routed through the liver. Their purpose is to reroute bile internally or into a drainage bag. NOTE: This is accd to CARLTON, it is not in the book. Surgical Tx: includes laparoscopic cholecystectomy & traditional cholecystectomy Laparoscopic cholecystectomy: performed through a small incision made thru the abdominal wall at the umbilicus. The abdominal cavity is pumped w/ CO2 to assist in inserting the laparoscope. NG tube insertion & drains may be present. There are less complications than w/ traditional surgery  ­Pre ­op: general anesthesia is used & pt teaching  ­Post ­op: less post ­op complications & abdominal pain than w/ traditional surgery Monitor O2 sats, incision site, drainage, VS Elevate HOB 30 ­45 degrees Fluids may be administered via NG tube or IV Soft diet is started after bs return Nurse encourages TCDB, splinting, spirometer use & early ambulation Pt should eat a diet low in...
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