this case presentation explains about cholelethiasis

1. CHOLELITHIASIS
PRESENTED BY :- MR. JUBER DONUR
(ASST. LECTURE)
BANGI INSTITUTE OF NURSING SCIENCES VIJAYAPURA.

2. 6. a) Define cholelithiasis.
b) Describe the pathophysiology and enlist clinical
Manifestation
. c) explain the pre and post operative nursing
management of Mrs. X who is suffering from cholelithiasis.

3. A) INTRODUCTION
• Located below the liver
• Pouch like structure
Secretion of bile by liver
Will stores and episodically
Enters into small intestine
Which help for digestion of
Fat.

4. DEFINITION
• Condition in which formation of stones into gall bladder
called CHOLELITHIASIS
• Choledocholithiasis :- condition in which stone forms into
common bile duct of the bladder called
choledolchoithoasis.

6. CLASSIFICATION
1. Choestrol cholelithiasis (yellow coloured stone)
2. Pigment cholelithiasis (bile cholelithiasis)- dark brown/
black colour
3. Mixed cholelithiasis – both stones

8. CAUSES
• Ediopathic
• Female
• Fat
• Fourty age
• Genetic
• High fat diet
• Cirhosis of liver
• Gall bladder inflammation
• Increases level of bilurubin
- calcuim salats

9. B) PATHOPHYSIOLOGY
Due to aetiology—>
cholesterol level suprificstion—>
hypomobility (decreased function of gall bladder)—>
Cholesterol nuclification( liqid cholestrolconverts into
crystal)—>
accreation (hyper secreation of mucus that makes stone solid)
—>
sign and symptoms of gallstones

10. CLINICAL MANIFESTATION
• Upper right abdominal pain
• Pain after fat meal
• Nausea and vomiting
• Clay coloured stool
• Dark coloured urine
• Burping (gas come out
through mouth)
• Diarrhoea
• Dehydration.
• Increased thirst
• Indigestion
• Malnutrition
• Weakness

11. DIAGNOSTIC
EVALUATION
• HISTORY TAKING
• PHYSICAL EXAMINATION
• X-ray CT MRI
• Blood test (increased
bilirubin)

12. MEDICAL MANAGEMENT
• Medications are not most
commonly used.
• Antibiotics
• Analgesics
• Anti diarrhoeal
• Anti emetics
• Anat acids, H2 blocker, PPI
• ACTIGALL ( dissolved the
stone and should take for
longer time)

13. C) SURGICAL MANAGEMENT
• Shock wave lithiotripsy
• Laproscopic
cholecystectomy

14. NURSING DIAGNOSIS
• Acute pain related to obstruction and inflammation.
• Risk for deficit volume related to diarrhoea and vomiting.
• Risk for imbalanced nutrition related to nausea and
vomiting
• Deficit knowledge related to disease condition
• Fear and anxiety related to hospitalisation.

15. Pre and post operative care
PRE OPERATIVE CARE
• Plan for OT
• Written consent from pt
• Explain procedures
• Check vitals
• Prepare for anaesthesia.
• Empty the bladder before
surgery
• Shave the area
POST OPERATIVE CARE
• Assess consciousness
• Vital sings
• Assess incisions
• Provide adequate fluid
• Health education