A. Nsleyknipper – Class Talk Fall 2016

Cholecystitis vs. Cholelithiasis

By: Lisa Agor, Jessica Dorthalina, Kendyl Egizi, and Ansley Knipper Cholecystitis Cholelithiasis Who? Anybody More common in women, especially as they age, > 40 years of age. What? Inflammation of the gallbladder, which can be acute or chronic. Patho: blocks the bile duct resulting in the inflammatory response. Calculi or gallstones. Patho: two types […]

By: Lisa Agor, Jessica Dorthalina, Kendyl Egizi, and Ansley Knipper

	Cholecystitis	Cholelithiasis
Who?	Anybody	More common in women, especially as they age, > 40 years of age.
What?	Inflammation of the gallbladder, which can be acute or chronic. Patho: blocks the bile duct resulting in the inflammatory response.	Calculi or gallstones. Patho: two types pigment or cholesterol; cholesterol stones are more common.
When?	S/S: nausea, vomiting, tenderness and rigidity of the upper right abdomen; and pain that may radiate to the midsternal area of the right shoulder.	Related to: symptoms can arise after eating meals rich in fried and fatty foods S/S: can be silent, epigastric distress, fullness, abdominal distention, vague pain in upper right quadrant. Can be infected resulting in fever, jaundice, changes in urine color (dark), changes in stool color (grey), and vitamin deficiencies
Where?	Gallbladder	Gallbladder, but can affect other systems including the GI tract, liver, and pancreas.
Why?	People at risk are individuals who have had prior surgeries, burns, and gallstones. “90% of patients with cholecystitis get gallstones”	Risk factors include obesity, multiparous. DM, cirrhosis, hemolysis, and contraceptives. “Five F’s” Fat (overweight) Forty (age near or above 40) Female Fertile (premenopausal- increased estrogen is thought to increase cholesterol levels in bile and decrease gallbladder contractions) Fair (gallstones more common in Caucasians)
How? (Tx)	Both have similar treatment: Pharmacologic: Ursodeoxycholic acid Nutrition: low fat foods, high in proteins and carbs. Nonsurgical: removal by instrumentation, shock wave (lithotripsy) Surgical: laparoscopic cholecystectomy	ERCP: used to dx; examines hepatobiliary system via fiberoptic endoscope; NPO several hours before; moderate sedation

Cholecystitis vs. Cholelithiasis

By: Lisa Agor, Jessica Dorthalina, Kendyl Egizi, and Ansley Knipper

	Cholecystitis	Cholelithiasis
Who?	Anybody	More common in women, especially as they age, > 40 years of age.
What?	Inflammation of the gallbladder, which can be acute or chronic. Patho: blocks the bile duct resulting in the inflammatory response.	Calculi or gallstones. Patho: two types pigment or cholesterol; cholesterol stones are more common.
When?	S/S: nausea, vomiting, tenderness and rigidity of the upper right abdomen; and pain that may radiate to the midsternal area of the right shoulder.	Related to: symptoms can arise after eating meals rich in fried and fatty foods S/S: can be silent, epigastric distress, fullness, abdominal distention, vague pain in upper right quadrant. Can be infected resulting in fever, jaundice, changes in urine color (dark), changes in stool color (grey), and vitamin deficiencies
Where?	Gallbladder	Gallbladder, but can affect other systems including the GI tract, liver, and pancreas.
Why?	People at risk are individuals who have had prior surgeries, burns, and gallstones. “90% of patients with cholecystitis get gallstones”	Risk factors include obesity, multiparous. DM, cirrhosis, hemolysis, and contraceptives. “Five F’s” Fat (overweight) Forty (age near or above 40) Female Fertile (premenopausal- increased estrogen is thought to increase cholesterol levels in bile and decrease gallbladder contractions) Fair (gallstones more common in Caucasians)
How? (Tx)	Both have similar treatment: Pharmacologic: Ursodeoxycholic acid Nutrition: low fat foods, high in proteins and carbs. Nonsurgical: removal by instrumentation, shock wave (lithotripsy) Surgical: laparoscopic cholecystectomy	ERCP: used to dx; examines hepatobiliary system via fiberoptic endoscope; NPO several hours before; moderate sedation

Cholecystitis vs. Cholelithiasis

By: Lisa Agor, Jessica Dorthalina, Kendyl Egizi, and Ansley Knipper

	Cholecystitis	Cholelithiasis
Who?	Anybody	More common in women, especially as they age, > 40 years of age.
What?	Inflammation of the gallbladder, which can be acute or chronic. Patho: blocks the bile duct resulting in the inflammatory response.	Calculi or gallstones. Patho: two types pigment or cholesterol; cholesterol stones are more common.
When?	S/S: nausea, vomiting, tenderness and rigidity of the upper right abdomen; and pain that may radiate to the midsternal area of the right shoulder.	Related to: symptoms can arise after eating meals rich in fried and fatty foods S/S: can be silent, epigastric distress, fullness, abdominal distention, vague pain in upper right quadrant. Can be infected resulting in fever, jaundice, changes in urine color (dark), changes in stool color (grey), and vitamin deficiencies
Where?	Gallbladder	Gallbladder, but can affect other systems including the GI tract, liver, and pancreas.
Why?	People at risk are individuals who have had prior surgeries, burns, and gallstones. “90% of patients with cholecystitis get gallstones”	Risk factors include obesity, multiparous. DM, cirrhosis, hemolysis, and contraceptives. “Five F’s” Fat (overweight) Forty (age near or above 40) Female Fertile (premenopausal- increased estrogen is thought to increase cholesterol levels in bile and decrease gallbladder contractions) Fair (gallstones more common in Caucasians)
How? (Tx)	Both have similar treatment: Pharmacologic: Ursodeoxycholic acid Nutrition: low fat foods, high in proteins and carbs. Nonsurgical: removal by instrumentation, shock wave (lithotripsy) Surgical: laparoscopic cholecystectomy	ERCP: used to dx; examines hepatobiliary system via fiberoptic endoscope; NPO several hours before; moderate sedation

Nephrotoxic Vancomycin

Vancomycin is an antibiotic often seen in the hospital and is used to treat infections like endocarditis, pneumonia, and Clostridium dififcile colitis. Vancomycin, especially the IV form, is eliminated almost entirely by the kidneys and should be cautiously used in patients with renal failure. When given to renal patients the nurse must closely assess for […]

Vancomycin is an antibiotic often seen in the hospital and is used to treat infections like endocarditis, pneumonia, and Clostridium dififcile colitis.

Vancomycin, especially the IV form, is eliminated almost entirely by the kidneys and should be cautiously used in patients with renal failure.

When given to renal patients the nurse must closely assess for signs of nephrotoxicity which include cloudy or pink urine, and change in function of the eighth cranial nerve. A nurse needs to monitor the patient for an increase in BUN and trough concentrations. To prevent other dangerous symptoms like “red man” syndrome or thrombophlebitis the nurse should infuse 1 g of IV Vancomycin over at least 60 minutes.

Nephrotoxic Vancomycin

Vancomycin is an antibiotic often seen in the hospital and is used to treat infections like endocarditis, pneumonia, and Clostridium dififcile colitis.

Vancomycin, especially the IV form, is eliminated almost entirely by the kidneys and should be cautiously used in patients with renal failure.

Nephrotoxic Vancomycin

Vancomycin is an antibiotic often seen in the hospital and is used to treat infections like endocarditis, pneumonia, and Clostridium dififcile colitis.

Vancomycin, especially the IV form, is eliminated almost entirely by the kidneys and should be cautiously used in patients with renal failure.

Welcome Blog (week 2)

Something about me: I am a dog person and I run on coffee. Favorite electrolyte: Potassium! This is the one electrolyte value I can always remember…3.5-5. Least favorite electrolyte: Chloride. It’s in so many things like normal saline, yet I still struggle to understand exactly what it does. The normal value is 97-107.

Something about me: I am a dog person and I run on coffee.

Favorite electrolyte: Potassium! This is the one electrolyte value I can always remember…3.5-5.

Least favorite electrolyte: Chloride. It’s in so many things like normal saline, yet I still struggle to understand exactly what it does. The normal value is 97-107.

Welcome Blog (week 2)

Something about me: I am a dog person and I run on coffee.
Favorite electrolyte: Potassium! This is the one electrolyte value I can always remember…3.5-5.
Least favorite electrolyte: Chloride. It’s in so many things like normal saline, yet…

Something about me: I am a dog person and I run on coffee.

Favorite electrolyte: Potassium! This is the one electrolyte value I can always remember…3.5-5.

Least favorite electrolyte: Chloride. It’s in so many things like normal saline, yet I still struggle to understand exactly what it does. The normal value is 97-107.

Welcome Blog (week 2)

Something about me: I am a dog person and I run on coffee.
Favorite electrolyte: Potassium! This is the one electrolyte value I can always remember…3.5-5.
Least favorite electrolyte: Chloride. It’s in so many things like normal saline, yet…

Something about me: I am a dog person and I run on coffee.

Favorite electrolyte: Potassium! This is the one electrolyte value I can always remember…3.5-5.

Least favorite electrolyte: Chloride. It’s in so many things like normal saline, yet I still struggle to understand exactly what it does. The normal value is 97-107.