CASE STUDY: Cholelithiasis

Prepared By: Paulin, Rose Anne Ramos, Jackie Ruaza, Michael San Miguel, Elena Santiago, Aizelle

INTRODUCTION

GOAL:

To present a comprehensive study on cholelithiasis in order to enhance the knowledge and develop the skills and attitudes of student nurses in the actual care and management of patients suffering from this disease.

OBJECTIVES:

• • • • • • • • •

Discuss the pathophysiology, incidence / prevalence, and mortality / morbidity associated with the disease being reviewed, along with the race, sex, and age range of persons typically affected; Recognize the typical clinical presentation, including common symptoms and physical examination findings; To formulate a comprehensive nursing care plan utilizing the nursing process. Administer proper medical/surgical care and recommend appropriate consultations, diets, and activities; List categories of medications useful in treatment and demonstrate familiarity with dosage regimens of appropriate medications; Provide suitable follow-up care; Institute prevention strategies for developing further complications; Discuss potential complications and prognosis; and To provide a continuous home care through the discharge plan.

NURSING HEALTH HISTORY

PHYSICAL ASSESSMENT

ANATOMY and PHYSIOLOGY

PATHOPHYSIOLOGY

DIAGNOSTIC PROCEDURES and LABORATORY RESULTS

NURSING CARE PLAN

• Readiness for enhanced knowledge related to preoperative preparation • Risk for infection related to abdominal incision • Risk for pain/discomfort related to abdominal incision.

DRUG STUDY

• • • • • • • • •

CEFUROXIME OMEPRAZOLE PARACETAMOL HYOSCYAMINE BUTYLBROMIDE METFORMIN HCL CEFTAZIDIME MEPERIDINE HCL INSULIN GLARGINE NPH INSULIN

DISCHARGE PLAN

M – MEDICINE • Advise the patient and the significant others to comply strictly with the prescribed medications in order to aid in the recovery state after surgery. • Discuss with the patient the things she needs to know about her medications. (e.g., side effects, adverse reactions) E – ENVIRONMENT AND EXERCISE • Maintain a quiet, pleasant, environment to promote relaxation. • Provide clean and comfortable environment. • Advise the patient to perform exercises within physical limits and to avoid fatigue by planning rest periods during the day. • Instruct the patient to breathe deeply and slowly during the periods of an activity. • Strenuous exercise and lifting should be avoided. T – TREATMENT • Instruct patient to comply with the home medications that would be given by his physician. • Teach patient about wound care. • Encourage rest, relaxation and proper nutrition.

H – HEALTH TEACHING • Instruct patients to avoid emotional stress. • Provide written and oral instructions about wound care, activity, diet recommendations, and medications. • Teach patient about caring for the stitches, hygiene and bathing. • Encourage patient to do the recommended light exercises such as walking. Avoid doing strenuous activities which could slow down his recovery. • Encourage him to comply with the dietary modifications; limit the intake of saturated fat to prevent the occurrence of serious postcholecystectomy side-effects. • Explain to patient to refer for untoward signs and symptoms immediately. O – OUT PATIENT FOLLOW-UP • Instruct the patient to consult the physician for any problems or complications encountered. • Remind patient that regular check-ups are important to ensure that the patient condition is constantly monitored by the doctor.

D – DIET • Advise patient to limit the intake of saturated fat and that she should eat smaller amounts of food during a single meal. • Eat three balanced meals a day; high in fiber, low in saturated fats. • Direct irritants such as spices, red and black peppers should be limited. S – SPIRITUALITY • Encourage patient to communicate with God. • Encourage patient to communicate with other people.

THE END Thank you for listening!

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