R.J. is a 52-year-old woman admitted to the hospital with acute abdominal pain. R.J. complains of…

R.J. is a 52-year-old woman admitted to the hospital with
acute abdominal pain. R.J. complains of right upper quadrant pain radiating to
the back. She has had previous episodes, usually occurring about 2 hours after
eating. This episode, however, is not resolving. R.J. also complains of nausea.
Her vital signs are BP 152/88 mm Hg, pulse 92 beats/min, and respirations 24
breaths/min and shallow. R.J. is a slightly obese female who states she has
recently been dieting to lose weight. Laboratory analysis includes a CBC with
slightly elevated WBCs, elevated bilirubin, and elevated alkaline
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R.J. is a 52-year-old woman admitted to the hospital with
acute abdominal pain. R.J. complains of right upper quadrant pain radiating to
the back. She has had previous episodes, usually occurring about 2 hours after
eating. This episode, however, is not resolving. R.J. also complains of nausea.
Her vital signs are BP 152/88 mm Hg, pulse 92 beats/min, and respirations 24
breaths/min and shallow. R.J. is a slightly obese female who states she has
recently been dieting to lose weight. Laboratory analysis includes a CBC with
slightly elevated WBCs, elevated bilirubin, and elevated alkaline phosphatase.
An IV is started, and R.J. is given meperidine (Demerol) IM for pain. R.J. has
been made NPO. An ultrasound of the gallbladder is ordered.

The following questions will guide your development of a
nursing care plan for this case study.

1. List subjective and objective data a nurse would want to
obtain about R.J.

2. List risk factors other than those R.J. has that would
put a client at risk for developing cholecystitis.

3. List two nursing diagnoses and goals for R.J.

4. The ERCP is successful in removing the CBD stone. The
decision is made to perform a laparoscopic cholecystectomy. What teaching will
R.J. need?

5. Why is meperidine (Demerol) the medication of choice for
pain control?

6. List at least three successful outcomes for R.J.

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