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Lab Values for Acute Cholecystitis (Nursing)

by Rhonda Lawes

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      Slides Gallbladder Cholecystitis Lab Work Diagnostics.pdf
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    00:01 Next up acute cholecystitis.

    00:04 Now, we have an a little bit older person there but this can happen and it's happening earlier and earlier in our patients.

    00:10 We're seeing younger and younger patients, but this sheet here once we're done is a fantastic cheat sheet for you to have right in your pocket when you're evaluating this type of lab.

    00:22 Now, let's look at the progression of cholecystitis remember early on just kind of don't feel good and digestive maybe some vague pain, it might refer to the right shoulder into the scapula must be include some vomiting, restlessness and diaphoresis.

    00:38 Those are early symptoms at start early, that's why we call them that.

    00:43 This is often when patients will not seek care because they think it's going to work itself out or they just don't feel good or they ate something bad.

    00:51 Now it's moving to acute and that's what we're focusing on now.

    00:56 Now we're going to have more severe pain might have a fever, chills, skin might be starting to look a little jaundice and you definitely have some inflammation.

    01:05 So as a nurse you're assessing for pain and there you have it on the CBC, leukocytosis, elevated white cells their heart rate may be fast, again, the restlessness and all this other stuff is going to be getting worse, the fever, the jaundice, now we might see some changes in the waste products leaving their body in the form of urine or stool.

    01:26 That abdomen would also be pretty stiff.

    01:29 So, if it progresses to chronic cholecystitis, we're going to talk about that and what happens to your lab values, but I wanted to stop for just a minute and give you a review of the progression from early, to acute to chronic, because even if that acute inflammation resolves, it could keep flaring up, and the patient ends up developing chronic cholecystitis.

    01:52 Now, that means they're going to have a history of they're going to tell you, every time I eat a lot of fried foods, I really don't feel good.

    02:00 That's what we mean of the history of fat and tolerance.

    02:04 Dyspepsia is just a big general term for you feel kind of just, or nauseated after you eat.

    02:10 Heartburn and be less socially unacceptable flatulence.

    02:14 All right, so we did a quick review of how that works.

    02:17 But now that we've reviewed the progression I want you to look at what you should evaluate in an acute attack like now when we're talking about acute attack, they're right there with you.

    02:28 We know the paint's more severe, they've got chills, and jaundice and inflammation.

    02:32 So there is a running list of what you're going to be thinking through, that's just a summary of what we just talked about.

    02:38 Here's your chance to really shine.

    02:41 What I want you to do is to go through each one of those bulleted items pause the video and think through can you answer the question, why does the patient have pain? What's going on in their body? Why might the patient be tachycardic and work through each one of those items, to make sure you can check your understanding of the content we have covered.

    03:05 Welcome back.

    03:06 Now let's take a look at the labs.

    03:08 Why are we looking for leukocytosis? Right. Because cholecystitis often comes with infection.

    03:15 Why are we looking for elevated bilirubin or alkaline phosphatase? Because that gallstone may be causing that back up and damage to those organs.

    03:24 Bilirubin will tell us about what's going on with draining of that bile down to the intestine, alkaline phosphatase is also going to let us know damage to the organs.

    03:35 So in acute cholecystitis, we're back to our cheat sheet.

    03:38 Look, you've got leukocytosis, elevated bilirubin and or alkaline phosphatase.


    About the Lecture

    The lecture Lab Values for Acute Cholecystitis (Nursing) by Rhonda Lawes is from the course Gallstones and Cholecystitis: Diagnosis (Nursing).


    Author of lecture Lab Values for Acute Cholecystitis (Nursing)

     Rhonda Lawes

    Rhonda Lawes


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