NURS 620 TEST 2 QUESTIONS AND ANSWERS WITH ACCURATE SOLUTIONS RATED A. 

Cholecystitis
Correct Answer -Inflammation of the gallbladder is usually due to stones
within the cystic duct, causing inflammation. If not, with stones very
serious.
SS: generalized GI complaints to intractable pain. C/o indigestion, nausea,
and vomiting, especially after high-fat meals. Acute: colicky-type pain that
localizes to RUP or epigastrium. It may radiate to the middle of the back,
interscapular area, or right shoulder. The pain increased with any
movement, including respiration. If the inflammation extends to the
peritoneal area, the pain worsens, muscles become rigid, and fever is
usually evident. may have mild fever.
PE: Pain over RUQ. Positive Murphy's sign (Press against under ribs and
have pt take a breath. Pt will hold breath when the hand touches liver/gall
bladder). Low-grade fever may have mild jaundice from edema of the
common bile duct. Hyperbilirubinemia should raise suspicion of
choledocholithiasis. Bowel sounds may be diminished.
Rebound tenderness, shaking chills, or increased fever - perforation -
surgery.
Cholecystitis DX
Correct Answer -CBC with mild elevation of WBC. (15K). ALT and AST may
be elevated to 300U/L. Bili can be as high as 4mg/dl.
U/s is good, Xray can show stones, and CT if perforation suspected.
Cholecystitis Tx
Correct Answer -In most cases, resolves spontaneously in 4 days.