So, let's look at the progression of cholecystitis.
Let's look at what a patient will appear and what they'll complain of early on in the symptoms.
So, it might be just kind of, just a vague indigestion,
pain and tenderness in the upper right quadrant, right?
Because we know that's where the gallbladder is located.
It might also refer to their shoulder, to their scapula,
so that's the typical presentation early on.
Now, pain may also include nausea and vomiting, restless,
they just can't get comfortable, and they may even be kinda sweaty.
So, early on, these are the symptoms of cholecystitis.
As it progresses, the pain is gonna become more severe.
Now, they might start to develop a fever.
Remember, our elderly won't likely show us fever,
but the pain's gonna become more severe, they show us fever, chills,
now we might start seeing the jaundice.
Okay, and we're looking for that inflammation.
So, what do you as a nurse? What are you assessing?
Well, you'll ask them lots of specific question about their pain.
We're gonna look at their white blood cell level.
We're gonna watch for signs of tachycardia, fast heart rate.
Does a patient appear to be restless? Like, they just can't get comfortable.
Do they have a fever? What does their skin look like?
Has there been any noted changes in their urine or stool appearance?
And we're gonna look at that abdomen and feel it and see does it feel rigid, is it tender?
So, we move from vague symptoms in the very beginning.
Now, you're gonna see progression to acute
which is when patients usually first start to reach out for help.
This is when they'll show up in the urgent care or their physician's office
to try to figure out what is going on.
Then it can progress, if not resolved, to chronic cholecystitis.
Okay, this means somebody who's got a gallbladder that's really struggling
and it happens over and over again.
So, acute inflammation resolves, but then it continues to reoccur.
So, they had it, they have an attack, it goes away, they think everything's okay,
and then it keeps popping up again and again.
Now, the gallbladder becomes kinda fibrotic and stiff and contracted
because after it's inflamed, that -itis, cholecystitis,
after it's gone through so many periods of being inflamed, it kinda gets stuck.
It gets real stiff and it's not able to concentrate bile very well or to empty efficiently.
Now, we've got an ongoing or chronic problem.
Now, the patient will likely report a history that they can't really handle certain foods,
they have dyspepsia which is difficulty, just don't -- feel kinda nauseated,
don't feel good after they eat, they may also have heartburn or excuse me, flatulence. Right?
So, these are always things that people are a little hesitant to talk about,
particularly if they are uncomfortable,
but I -- it's important that you understand the progression early on.
First attack, just kind of uncomfortable, can't get settled.
If that attack progresses, pain is gonna become a little more severe,
they might have a fever, might be a little sweaty,
it's gonna be a different scenario and most likely when they'll reach out for help.
But then, it becomes chronic.
Now, we have a different problem and likely, we'll need to have the gallbladder removed.