NGN Case Study Title: Cholelithiasis/Cholecystitis and Open Cholecystectomy Scenario: A 60-year-old obese female is bein
Posted: Fri Jul 15, 2022 5:21 pm
NGN Case Study
Title: Cholelithiasis/Cholecystitis and OpenCholecystectomy
Scenario: A 60-year-old obese female is beingseen in her primary care provider’s office with a possible historyof gallstones and now with a possible diagnosis of cholecystitis.Her daily medications include Zestril (lisinopril) for a 5-yearhistory of hypertension and a multivitamin. When asked aboutexercise and diet, the patient reports that she eats mostly fastfood and spends most of the day in her recliner watching TV. Thepatient reports that in the past month she has had progressivelyworse indigestion and upper right quadrant pain that occurs a fewhours after meals and is especially severe when she goes to bed.Additionally, the pain has started to radiate to the rightshoulder. Using a pain intensity scale, the patient reports it tobe 6/10 to 8/10. The pain subsides after a few hours, but thepatient reports that her right upper quadrant always feelstender.
1. NGN Item Type: Extended Drag and Drop
Place an X (or drag and drop) to indicate which patientassessment findings require follow-up by the nurse at thistime.
Assessment Finding
Assessment Finding That Requires Follow-Up
Right upper quadrant tenderness
Patient is obese.
Dark amber colored urine
Patient oral temperature = 100.4°F (38°C)
Patient reports that she urinates 4-5 times per day.
Rationale for the above choices:
Cognitive Skill: Recognize Cues
2. NGN Item Type: Extended Response
Which nursing assessment findings support the patient’s probablediagnosis of cholecystitis? Select all thatapply.
_____ A. Jaundice
_____ B. Pain isworse after meals and when lying down
_____ C. BP160/82
_____ D. Patientreports indigestion
_____ E. Abdomen is soft and non-distended
_____ F. Intermittent right shoulder pain
_____ G. WBCcount 12000/mm3
Rationale for the above choices:
Title: Cholelithiasis/Cholecystitis and OpenCholecystectomy
Scenario: A 60-year-old obese female is beingseen in her primary care provider’s office with a possible historyof gallstones and now with a possible diagnosis of cholecystitis.Her daily medications include Zestril (lisinopril) for a 5-yearhistory of hypertension and a multivitamin. When asked aboutexercise and diet, the patient reports that she eats mostly fastfood and spends most of the day in her recliner watching TV. Thepatient reports that in the past month she has had progressivelyworse indigestion and upper right quadrant pain that occurs a fewhours after meals and is especially severe when she goes to bed.Additionally, the pain has started to radiate to the rightshoulder. Using a pain intensity scale, the patient reports it tobe 6/10 to 8/10. The pain subsides after a few hours, but thepatient reports that her right upper quadrant always feelstender.
1. NGN Item Type: Extended Drag and Drop
Place an X (or drag and drop) to indicate which patientassessment findings require follow-up by the nurse at thistime.
Assessment Finding
Assessment Finding That Requires Follow-Up
Right upper quadrant tenderness
Patient is obese.
Dark amber colored urine
Patient oral temperature = 100.4°F (38°C)
Patient reports that she urinates 4-5 times per day.
Rationale for the above choices:
Cognitive Skill: Recognize Cues
2. NGN Item Type: Extended Response
Which nursing assessment findings support the patient’s probablediagnosis of cholecystitis? Select all thatapply.
_____ A. Jaundice
_____ B. Pain isworse after meals and when lying down
_____ C. BP160/82
_____ D. Patientreports indigestion
_____ E. Abdomen is soft and non-distended
_____ F. Intermittent right shoulder pain
_____ G. WBCcount 12000/mm3
Rationale for the above choices: