CHAPTER 7 Gastrointestinal System^289
- Nausea and vomiting, especially following fatty foods
- Loss of appetite
- Fever
- Increased air in intestinal tract (eructation, flatulence)
- Pruritis (itching) of skin due to build-up of bile salts
- Clay-colored stools due to lack of urobilinogen in gut (normally converted
from bilirubin which was blocked with bile flow) - Jaundice—yellowish skin and mucous membrane discoloration
- Icterus—yellowish discoloration of sclera (white of eye)
- Dark, foamy urine as kidneys attempt to clear out bilirubin
INTERPRETING TEST RESULTS
- Ultrasound of gallbladder shows cholelithiasis, inflammation.
- HIDA scan (hepatic iminodiacetic acid) may be more sensitive than ultra-
sound in showing obstructed duct. - CT scan shows inflammation or cholelithiasis.
- MRCP (magnetic resonance cholangiopancreatography).
- ERCP (endoscopic retrograde cholangiopancreatography).
- Bilirubin direct (conjugated) and indirect (unconjugated) will be elevated if
there is obstruction. - White blood cell (WBC) count elevation with inflammation.
- Alkaline phosphatase, aspartate aminotransferase (AST), and lactate dehy-
drogenase (LDH) will be elevated with abnormal liver function.
TREATMENT
- Low-fat diet.
- Intravenous fluid replacement for vomiting.
- Administer antiemetics for control of nausea and vomiting:
- prochlorperazine
- trimethobenzamide
- Replace fat-soluble vitamins (A, D, E, K) as needed.
- Administer analgesics for adequate pain control:
- meperidine