Symptoms of a Biliary Colic: Pain (Nursing)

00:00 Let's start with pain. So, pain is in the upper right side or middle of the abdomen.

00:06 Don't just memorize that. Think about what you know.

00:09 You know that your liver is over here, right? It's on the right side of my body.

00:14 You know that the liver is connected to the gallbladder by the hepatobiliary system, so it would make logical sense that pain is gonna be in the upper right side or maybe even over a little bit in the middle of the abdomen.

00:28 Again, abdominal pain can move all around and we'll look at that, but think about where the organs are located and why it makes sense that they will most likely complain of pain on the right side, all right? Now, some people have a typical pain, but we're giving you what you will most likely see.

00:46 Now, what about the description of pain? Well, the pain can either be dull or it can be sharp. It just depends on what's going on.

00:55 Now, it usually has an abrupt onset.

00:57 That means it starts, boom, kind of almost without warning, but then it can become constant.

01:03 It lasts 15 minutes up to, look at that, 5 hours.

01:08 Can you imagine what that would feel like as a patient? So, they're gonna come into, they're gonna be complaining of pain, it's gonna be probably in the upper right or maybe in the middle of the abdomen.

01:18 It may be dull, it may be sharp, it may have come on quickly, and it may last for a very long period of time.

01:26 Now, it can also go to their back. It's usually steady and it may even spread to the back.

01:33 Now, why is that? Easy way to remember, that gallbladder is right here, right? And it is causing such excruciating pain.

01:40 Pain is shooting out this way and pain is shooting out your back.

01:44 So, keep that in mind that that's another way that pain can be right, middle, or even in the back in the same general area.

01:54 Let's talk about how this pain might look differently or how symptoms might look differently across the lifespan.

02:00 First up, yup, you've got our favorite elderly patient, our Lecturio.

02:05 There you go. In the elderly, the first or only symptoms may be more systemic.

02:10 With a middle-aged adult, they're gonna be pretty focus, but with an older client, they may be more systemic, meaning kind of, all over and not as specific. So, they may just not feel good.

02:23 They may have anorexia, which means they don't feel like eating.

02:26 They may have some nausea and vomiting, weakness and fever.

02:30 This is how it started with my dad.

02:33 This is how -- this was the beginning of our journey of figuring out that his gallbladder had to go.

02:39 He just didn't feel like himself, he couldn't really eat very much, he didn't feel like eating, and he had this emesis, which made him dehydrated.

02:48 So, keep an eye on that because the elderly clients are particularly at risk for becoming dehydrated.

02:55 If they have a lot of emesis, nausea, and vomiting, they don't wanna drink much on top of that so that's a really important critical area to be on the alert for.

03:04 Now, sometimes fever doesn't develop.

03:08 So, if this gallbladder is infected, sometimes the elderly don't show us fever.

03:13 Well, we already know that from other things, right? Their immune system is kind of wearing out.

03:19 It's not as strong as it was when they were in their 30s.

03:22 So, just like when an elderly client has a UTI, they don't always show us fever, same thing may happen if with a gallbladder attack.

03:30 Now, another favorite group of people are little pediatric patients.

03:35 In young children, some of them have that, underline that word, acalculous cholecystitis because I know you already know what that means.

03:45 A, means without, calculous refers to the stone.

03:49 So, they have itis or inflammation, right? In their chole in the gallbladder.

03:55 Okay, that was a lot of words. Let's slow it down and look at it again.

03:59 Acalculous means without a stone.

04:02 So, underline that and write yourself a quick note in your notes.

04:06 Cholecystitis is what we're talking about, right? That's the inflammation. That's part of the gallbladder attack.

04:12 So, in pediatric patients, they might have acute without a stone cholecystitis and it usually happens after a febrile illness and so you wanna keep an eye on them.

04:24 After a febrile illness, they start showing you some unusual symptoms.

04:29 So, we may not know what caused it, but it often happens without a stone.