Clinical Reasoning Assessment Scenario Essay Example | Topics and Well Written Essays - 2000 words

Clinical Reasoning Assessment Scenario - quiz ExampleDiagnosis is an abstraction of signs, symptoms, and inferences based on the affected role assessment and scientific knowledge of the tending view as (Malen, 1986). This paper will provide the nursing diagnosis and the supporting evidence for postoperative cholecystitis and cholylithiasis patient. The patient is Cicek Olcay, 53 years old, Turkish, and admitted at Day Procedure Unit or DPU (Bullock and Henze, 1999). All admission postulatements had been sedate and indicated, the checklist completed. Her gall bladder has been removed and pain was only experienced during a transition or ship to the ward from the post anaesthetic recovery room or P.A.R.U. Pathophysiology of cholecystitis and cholelithiasis it is an acute inflammation of the gall bladder associated with obstruction of by the gall stones. The causes can be that common bile duct stones were formed in the bile duct, or they may be formed in and transported from the gall bladder (Doenges et al, 2010). It was suggested that Cholelithiasis is usually well while Cholecystitis can result if stone becomes lodged in one of the ducts (Cuschieri, Dubios, Mouiel, Mouret, Becker, Buess, G, et al, 1991). Etiology The stones usually develop in and obstruct the common bile duct or the cystic duct it is also found in the hepatic, small bile, and pancreatic ducts. 90% of cases involve stones in the cystic duct or calculous cholecystitis, and the early(a) 10% involve cholecystitis without stones or acalculous cholecystitis according to Gladden & Migala (2007). The stones are made up of cholesterol, calcium bilirubinate, or a mixture caused by changes in the bile composition. Bile cultures are positive for bacteria in 50% to 75% of cases but bacterial proliferation may be a result or progeny of cholecystitis, but never the cause (Gladden & Migala, 2007). Other causes include stasis of bile or bacterial infection or ischemia of the gallbladder. The failure to remove impacted stone can lead to bile stasis or bacteriemia and septicemia causing cholangitis which is considered a medical emergency. The statistics for morbidity of bilestones are two to three times more(prenominal) frequent in females than in males. The perforation occurs in 10% to 15% of cases, and 25% to 30% of clients either require surgery or develop complications (Gladden & Migala, 2007). Mortality was indicated that about 10,000 deaths occur annually about 7,000 deaths result from gallstone complications, such as acute pancreatitis. There is 4% mortality order for calculous cholecystitis and about 10-50% rate for acalculous cholecystitis. Care Setting Severe acute attacks of cholecystitis and cholelithiasis usually require brief hospitalization. This type of care is relevant for the acutely ill, hospitalized client and surgery is usually performed after symptoms for the illness have subsided (Bisgaard et al, 1999). Nursing Priorities The priority for the nurse during the care for patient with cholecystitis and cholelithiasis is to relieve pain and promote rest. In addition, the patient should be assisted to adduce fluid and electrolyte balance, prevent complications, and provided with information about disease process, prognosis, and treatment needs (Doenges et al, 2010, 498). The following are innate data, objective data, vital sign, nursing