Following several days of intermittent upper right quadrant pain, a 29-year-old obese, Native American woman has been diagnosed with cholelithiasis
The nurse at the clinic has taught the client about the pathophysiology and contributing factors to her health problem, as well as some of the likely treatment options. Which of the following statements by the client demonstrates a sound understanding of her diagnosis?
A)
"All in all, I guess this is a result of the fact that I've been eating a diet too high in cholesterol for too long."
B)
"Several factors like my genetics and gender may have contributed to this, but I'm glad that medications can cure it."
C)
"This explains why my skin was yellow-tinged lately and why I had those pains that spread to my upper back and right shoulder."
D)
"I suppose the fever and vomiting I had this week was probably a sign of my gallstones too."
Ans:
C
Feedback:
Gallstones can be caused by abnormalities in the composition of bile (increased cholesterol) and stasis of bile. The formation of cholesterol stones is associated with obesity and occurs more frequently in women. These factors cause the liver to excrete more cholesterol into the bile. Estrogen reduces the synthesis of bile acid in women. Cholesterol stones are extremely common in Native Americans. Jaundice and pain that radiates to the upper back and right shoulder are noted signs and symptoms of cholelithiasis. While cholesterol is a key element in the formation of gallstones, the particular amount ingested in the diet is not central to the development of the problem. Surgery, not medication, is the normal treatment modality, and fever and nausea are more closely associated with cholecystitis rather than cholelithiasis.
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