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Yanai Gonzalez

Medical Surgical Nursing1

Presentation about: Pancreatitis, Cholecystitis, and Cholelithiasis.

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Objectives

You will be able to understand the definition and pathophysiology of pancreatitis, cholecystitis, and cholelithiasis.

Name the causes, risk factors, and the affected population for these conditions.

Recognize the signs, symptoms, and diagnostic methods.

Investigate treatment options and nursing management strategies.

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Introduction

Pancreatitis, cholecystitis, and cholelithiasis are common gastrointestinal conditions with significant health impacts. According to the CDC, approximately 275,000 people are hospitalized annually due to acute pancreatitis in the United States. Gallstones, a major cause of cholecystitis and cholelithiasis, affect about 10-15% of the U.S. adult population.

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Pancreatitis
Statistics

According to the CDC, there are approximately 275,000 hospitalizations for acute pancreatitis each year in the U.S.

Cholecystitis and Cholelithiasis Statistic

Gallstones affect 10-15% of the U.S. population, with 1-3% developing acute cholecystitis annually.

What is the Anatomy and Physiology of these conditions?

The pancreas, gallbladder, and biliary system play crucial roles in digestion!!!

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Pancreas

Exocrine Function: Produces digestive enzymes (amylase, lipase, proteases) that break down carbohydrates, fats, and proteins in the small intestine

Endocrine Function: Produces hormones (insulin, glucagon) that regulate blood sugar levels.

Gallbladder

Function: Stores and concentrates bile produced by the liver, releases bile into the small intestine to aid digestion of fats.

Biliary System

Component: Liver, gallbladder, bile ducts.

Function: Transports bile from the liver to the gallbladder and small intestine.

Description of each conditions

**Pancreatitis**

Pancreatitis: Inflammation of the pancreas.

Pathophysiology: Digestive enzymes activate within the pancreas, causing tissue damage and inflammation.

Causes: Gallstones, chronic alcohol use, certain medications like antidiabetic drugs and ACE inhibitor, or trauma.

Risk Factors: Heavy alcohol use, gallstones, smoking, high triglyceride levels.

Sings and Symptoms: Severe abdominal pain, nausea, vomiting, fever, rapid pulse.

Affected population: More common in adults, particularly those with a history of gallstones or heavy alcohol use.

Treatment and Diagnosis

Diagnosis: Blood tests(amylase and lipase), CT scan, MRI, ultrasound.

Treatment: Non-pharmacological: Fasting, hydration (IV fluids), nutritional support.

Treatment: Pharmacological: Pain management, antibiotics if infection is suspected.

Nursing Management

Interventions: Monitor vital signs, manage pain, ensure adequate hydration, support nutritional needs.

Rationale: Prevent complications, alleviate pain, maintain fluid and electrolyte balance.

Cholecystitis

Definition: Inflammation of the gallbladder, often due to a blocked bile duct.

Pathophysiology: Blockage leads to bile accumulation, causing inflammation and infection.

Causes(Etiology): Gallstones, bile duct problems, tumors infections.

Risk Factors: Obesity, female gender, age over 40, pregnancy, certain ethnicities (e.g., Native Americans)

Affected population: Common in middle-aged women, obese individuals’ pregnant women.

Signs and symptoms: Severe right upper abdominal pain, nausea, vomiting, fever, jaundice.

Diagnosis: Ultrasound, HIDA scan, CT scan, blood tests( elevated white blood cells, liver enzymes.)

Treatment

Non-pharmacological: Fasting, hydration(IV fluids), surgery (cholecystectomy).

Pharmacological: Pain management, antibiotics if infection is present.

Nursing Management

Interventions: Monitor for signs of infection, manage pain, prepare for possible surgery(if doctor requested)

Rationales: Prevent complications, alleviate pain, ensure patient is ready for surgical intervention If necessary.

Cholelithiasis

Description/Definition: Formation of gallstones within the gallbladder.

Pathophysiology: Imbalance in the substances that make up bile, leading to crystallization and stone formation.

Causes: Excess cholesterol in bile. Bile stasis, genetic factors.

Risk factors: Obesity, rapid weight loss, high-fat diet, pregnancy.

Affected population: Women, older adults, obese individuals, those with a family history.

Cholelithiasis

Sings and symptoms: Often asymptomatic but can cause biliary colic (intermittent abdominal pain), nausea, vomiting.

Cholelithiasis

Diagnosis: Ultrasound, CT scan, MRI, blood tests.

Treatment

Non-pharmacological: Diet modification, weight management, surgery (cholecystectomy)

Pharmacological: Bile acid pills to dissolve stones.

Nursing Management

Interventions: Educate on diet and lifestyle changes, monitor for complications, support during diagnostic procedures.

Rationale: Prevent stone formation, alleviate symptoms, ensure patient understands lifestyle modification.

Conclusion

In summary, pancreatitis, cholecystitis, and cholelithiasis are significant conditions affecting the pancreas and gallbladder, each with distinct definitions, pathophysiology, causes, risk factors, and affected populations. Understanding the clinical manifestations and diagnostic methods for these conditions is crucial for early detection and effective treatment.

References

Ignatavicius, D. D., Workman, L. M., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-Surgical Nursing: Concepts for Interprofessional and Collaborative care (10th ed.). Elsevier.

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