00:00
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.
00:55
Now we're going to
have more severe pain
might have a fever, chills,
and you definitely
have some inflammation.
01:02
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
That abdomen would
also be pretty stiff.
01:19
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.
01:42
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.
01:50
That's what we mean of the
history of fat and tolerance.
01:54
Dyspepsia is just a big general
term for you feel kind of just,
or nauseated after you eat.
02:00
Heartburn and be less socially
unacceptable flatulence.
02:04
All right, so we did a quick
review of how that works.
02:07
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.
02:17
We know the paint's more severe,
they've got chills,
and inflammation.
02:21
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.
02:28
Here's your chance
to really shine.
02:31
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.
02:55
Welcome back.
02:56
Now let's take a
look at the labs.
02:58
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.
03:08
So in acute cholecystitis,
we're back to our cheat sheet.