Repetition of Biliary Colic (Nursing)

by Rhonda Lawes, PhD, RN

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      Slides Gallbladder Cholecystitis Biliary Colic Symptoms.pdf
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      Reference List Medical Surgical Nursing and Pathophysiology Nursing.pdf
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    00:00 Hi, welcome to our video series on the gallbladder.

    00:04 Now, we're gonna take a look at cholecystitis or a gallbladder attack.

    00:08 I want you to understand what the symptoms are you're most likely to see and how you should assess your patient.

    00:14 Now I do wanna warn you that we have a pretty graphic image up next.

    00:18 So, I didn't wanna surprise you. Ready? What? Not what you expected? Well, let me just tell you, you would understand how graphic this really is if you ever experienced a gallbladder attack yourself.

    00:35 Now, you'll see on the slide there, we say biliary colic because that's another name.

    00:40 Let's look at this in a much more fun way.

    00:43 We came up with a wanted poster for you there.

    00:45 So, you've got the gallbladder full of gallstones with the cowboy hat on.

    00:50 Yeah, because they wanted you to know that biliary colic is also known as a gallbladder attack or a gallstone attack.

    00:57 So, when you hear that terminology, it's the same thing.

    01:01 Just think about our gallbladder as the bad guy on a wanted poster.

    01:05 That will help you remember that medical terminology.

    01:07 Now, we've got this picture for you here.

    01:11 Let me get you oriented a little bit.

    01:13 Every time you look at a picture when you're studying, I want you to think about what am I looking at, why am I looking at this, how would it help me keep my patient safe? We see at the top, we say biliary colic because what we want to show you was that excruciating pain, but let me give you some landmarks.

    01:33 If you take your finger and you follow that green line, up just below the letter C in biliary colic, what organ is supposed to be there in the human body? Right, it's the liver. Good, good.

    01:47 Now, if you follow that back down, so we came from the liver, then you see that first stop there, is the gallbladder and it's full of stones, which is why it's featured in this video.

    01:57 Now, if you continue following that green line, right? That's the hepatobiliary system.

    02:03 That's the system or the plumbing that drains bile from your liver that some of it be stored in the gallbladder, and then it travels on down to the small intestine.

    02:12 So, if you follow that green line, you see there's like a little window cut out of that pink tube.

    02:20 Well, that pink tube represents where your stomach connects to your small intestine.

    02:26 So, if you were gonna draw in the organ that's at the end of that pipe, that's where your stomach would be.

    02:32 Now, what do you think that kind of yellowish-colored organ is right there where everything connects? We have the liver, drains down past the gallbladder, then it all end up in the small intestine.

    02:44 That's the pancreas. Not a particularly attractive organ, but it is really useful.

    02:50 It's both an endocrine and an exocrine organ.

    02:54 I know we're talking about biliary colic, but all these organs are interconnected and when one of them has a problem, it can impact all of them because of those stones.

    03:07 But when we're talking about biliary colic, we mean the pain that's caused by the stone.

    03:12 Now, you already know that the liver drops down the bile, right? And it should be travelling down that duct system, but when a stone is formed in the gallbladder and you see that one that's caught right in the neck of that tiny little one? It doesn't look like that big a deal, but it can cause big problems.

    03:29 As you continue following it, you see the stone that's really lodged in the main part of the duct.

    03:35 Now, that duct is constantly moving trying to drain bile.

    03:39 When something clogs it up, that's where the pain comes from.

    03:44 It starts to have this spasm. That's why your patient is so miserable when this happens, because biliary colic is severe spasms in the bile ducts when it's blocked by a stone or even by inflammation.

    03:57 So, I can have a problem and it's called acalculous. That means without a stone.

    04:03 The inflammation is so severe, it's also obstructed that flow of bile.

    04:08 Now, this usually happens, this biliary spasm, usually happens 3-6 hours after a high-fat meal or when the patient lies down.

    04:18 So, those are really important patient assessments.

    04:21 Ask your patient, "Hey, what makes the pain worse?" "When have you noticed it starting?" "Have you noticed it starting after a meal?" "What's your typical meal?" Those are the kinds of questions that we can ask patients to get the best clinical information out of them.

    04:36 See, by us understanding how the body works, where the organs are, what the symptoms are like, we can ask better questions, therefore, we keep our patients safer and get them better care.

    04:48 So, when you're thinking about the symptoms of a gallbladder attack, what am I looking for when I'm assessing my patient? I want you to think about two main areas.

    04:57 First, pain. And the patient's gonna wanna tell you all about that.

    05:01 Our job is to help guide them by asking specific questions that will give us detailed information about their pain.

    05:08 The second category is weird color changes.

    05:12 Okay, so, these color changes can happen in your urine, stool, or in their skin.

    05:17 So, two categories when we're thinking about gallbladder attack.

    05:21 Pain and color changes in some pretty interesting places.

    About the Lecture

    The lecture Repetition of Biliary Colic (Nursing) by Rhonda Lawes, PhD, RN is from the course Gallstones and Cholecystitis: Introduction and Symptoms (Nursing).

    Included Quiz Questions

    1. Gallbladder attack
    2. Gallstone attack
    3. Severe spasms in the bile duct
    4. Liver attack
    5. Pancreas attack
    1. 3–6 hours
    2. Immediately
    3. 1–2 days
    4. 24 hours
    1. Pain
    2. Color change in urine
    3. Color change in stool
    4. Itching
    5. Coughing

    Author of lecture Repetition of Biliary Colic (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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