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    Pathophysiology - Obstructive Jaundice

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    Abigail Lonogan
    1. The patient presented with choledocholithiasis and cholangitis due to a history of cholelithiasis and cholecystectomy. Diagnostic exams revealed multiple bile duct stones. 2. Surgical management involved cholecystectomy and insertion of a percutaneous transhepatic biliary drainage tube for bile drainage. 3. Post-operatively, the patient experienced fever, jaundice, and acute pain related to the drainage tube. Nursing care focused on monitoring for infection, managing pain, and providing health education.

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    Pathophysiology - Obstructive Jaundice

    Uploaded by

    Abigail Lonogan
    2K views3 pages
    1. The patient presented with choledocholithiasis and cholangitis due to a history of cholelithiasis and cholecystectomy. Diagnostic exams revealed multiple bile duct stones. 2. Surgical management involved cholecystectomy and insertion of a percutaneous transhepatic biliary drainage tube for bile drainage. 3. Post-operatively, the patient experienced fever, jaundice, and acute pain related to the drainage tube. Nursing care focused on monitoring for infection, managing pain, and providing health education.

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    Simple pathophysiology of obstructive jaundice secondary to choledocholithiasis

    Original Title

    Pathophysiology | Obstructive Jaundice

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    1. The patient presented with choledocholithiasis and cholangitis due to a history of cholelithiasis and cholecystectomy. Diagnostic exams revealed multiple bile duct stones. 2. Surgical management involved cholecystectomy and insertion of a percutaneous transhepatic biliary drainage tube for bile drainage. 3. Post-operatively, the patient experienced fever, jaundice, and acute pain related to the drainage tube. Nursing care focused on monitoring for infection, managing pain, and providing health education.

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    2K views3 pages

    Pathophysiology - Obstructive Jaundice

    Uploaded by

    Abigail Lonogan
    1. The patient presented with choledocholithiasis and cholangitis due to a history of cholelithiasis and cholecystectomy. Diagnostic exams revealed multiple bile duct stones. 2. Surgical management involved cholecystectomy and insertion of a percutaneous transhepatic biliary drainage tube for bile drainage. 3. Post-operatively, the patient experienced fever, jaundice, and acute pain related to the drainage tube. Nursing care focused on monitoring for infection, managing pain, and providing health education.

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    ETIOLOGY/ DISEASE MEDICAL SIGNS AND DIAGNOSTIC NURSING EXPECTED NURSING

    MANAGEMENT
    RISK FACTORS PROCESS DIAGNOSIS SYMPTOMS EXAMS DIAGNOSIS OUTCOMES INTERVENTIONS

    PREDISPOSING FACTORS PRECIPITATING FACTORS


     High sodium and fat diet  Cholecystectomy last 2015

    Bile in gallbladder become lithogenic

    Cholesterol become supersaturated and is


    kept in solution by bile acids and lecithin

    High levels of deoxycolate occur, which


    causes higher cholesterol secretion

    Nucleation occurs

    Formation of cholesterol crystals Cholelithiasis


    Stone obstructs and inflames surrounding CT Scan Result:
    tissue of the common bile duct Multiple choledocolithiases with
    intra-extrahepatic bile duct ectasia

    Intermittent obstruction
    UTZ Result:
    Multiple choledocholithiases (CBD
    and left main intrahepatic ducts) with
    intra and extrahepatic bile duct
    dilatation

    Choledocolithiasis
    Liver is obstructed, which is Stone blocks secretion of Biliary tract cannot transport bile
    the site for hematopoiesis pancreatic enzymes to the intestine
    Surgical management:
    Cholecystectomy
    CBC Result: CT Scan Result: Plump pancreas Bile stasis
    Hgb = 79
    Hct = 0.22
    WBC = 29.40
    RBC = 2.95 Pancreatitis Bile backs up into liver and
    Platelet = 587 injures ductal tissue

    Dizziness Pharmacologic
    management: Epo
    Ineffective tissue perfusion related to Acute Cholangitis Routine Chemistry Results:
    decreased hemoglobin count  Increased direct bilirubin
     Increased total bilirubin
     Increase alkaline
    phosphatase
     Assess capillary refill, skin color, Yellow discoloration of skin Fever
    mucous membrane and mucous membrane
     Check mental status
     Elevate head of bed
     Provide quiet environment
     Ensure safety by raising side rails Obstructive Jaundice Hyperthermia may be
     Render health teachings such as: related to ongoing process
    a) avoid straining b) deep
    breathing exercise c) eat foods
    rich in iron Risk for Infection Surgical management:
    Insertion of PTBD tube  Monitor VS especially
    temperature
     Administer prescribed antipyretic
     Report decrease in pain Pharmacologic medication
     Demonstrate use of relaxation management: Pain  Encourage to increase fluid intake
    techniques Metronidazole and
    Pip Taz

    Acute pain related to presence Pharmacologic


    of PTBD tube management: Paracetamol

     Assess pain characteristics  Decrease in


     Report decrease in  Assist in re-positioning temperature to
    pain  Facilitate DBE within normal
    Pharmacologic  Encourage adequate rest range
     Demonstrate use of management: Tramadol
    relaxation techniques and sleep

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