NURS 621 (Advanced Pathophysiology) LATEST UPDATED (Liver, Gall bladder, Pancreas) EXAM 5 STUDY GUIDE

Gallbladder
1. A&P of gallbladder and function
a. Pear shaped organ on the inferior side of the liver in the RUQ
b. Holds about 45mL of bile but secretes 600-800mL of bile per day
i. Bile is formed in the liver and excreted into hepatic ducts
which form the common duct,this joins the pancreatic
duct and empties into the duodenum
ii. Bile helps digest food, especially the emulsification and
digestion of fats and fat solublevitamins (ADE and K)
c. Under sympathetic and parasympathetic nervous control so we
don’t have conscious control overit
d. The sphincter of Oddi regulates bile flow into the duodenum
e. The sphincter of Boyden regulates bile flow into the common duct
f. You can live without your gallbladder, it is not essential for life
2. Assessment data
a. Radiology Diagnostic Tests
i. Ultrasound (US) – looks for stones, sludge, or
malformations, test is painless and non-invasive
ii. Hida Scan – looks for gallbladder function of production
and flow of bile from liver to small intestine, ejection
fractions are formed when injected cholecystokinin is
given tomimic food causing the gallbladder to eject bile,
test lasts an hour and the amount of bile is measured to
show how well it functions
1. Pts must be NPO for 2 hours prior to scan
2. Pts who have not eaten for 24 hours can have false
positives
3. Educate to drink lots of water to flush radioactive
material out
iii. ERCP – visualizes gallbladder, cystic duct, common hepatic
duct, and common bile ductsthrough endoscopy
1. Pts must be NPO after midnight and have informed
consent
2. Treated with throat spray (local anesthesia) to numb gag
reflex
3. Complications include perforation, pancreatitis, and
aspiration
4. Lay patients on left side
lOMoAR cPSD|42147428
5. Post op- assess for gag reflex, remain NPO until it
returns