Choledocholithiasis Patient Applied to Endoscopic Retrograde Cholangio Pancreatography (ERCP) and Nursing Care: A Case Report

Year 2023, Volume: 18 Issue: 3, 117 - 124, 20.11.2023

Servet Kalyoncu , Özlem Ceyhan

https://doi.org/10.17517/ksutfd.1276159

Abstract

Choledocholithiasis refers to the presence of gallstones in the common bile duct. Choledocholithiasis is more common in the elderly due to physiological dilatation of the common bile duct with age. Choledocholithiasis usually causes abdominal pain defined as biliary colic. It is accompanied by nausea and vomiting. Many complications such as acute cholangitis and acute biliary pancreatitis may develop in patients with choledocholithiasis. The aims of nursing care in patients with choledocholithiasis with complications are to detect signs and symptoms early, to provide self-care, to improve quality of life and well-being, to plan appropriate nursing interventions before, during and after the Endoscopic Retrograde Cholangio Pancreatography (ERCP) procedure, to follow the complications that may develop during and after the ERCP procedure and to implement the necessary nursing interventions, and to educate the patient and his family. A 56-year-old patient with a known diagnosis of ulcerative colitis (27 years), arrhythmia and DM presented to the emergency department because of fullness and pain in the epigastric region for 12 days and was admitted to the ward with a diagnosis of choledocholithiasis. The case was evaluated with Marjory Gordon's Functional Health Patterns Nursing Care Model and nursing care was provided. The necessary permission was obtained from the patient and her family for the study and publication. The nursing diagnoses of acute pain, nausea, hyperthermia, nutrition less than the body requirement due to anorexia, activity intolerance due to fatigue, deterioration in skin integrity due to jaundice and itching, fluid electrolyte imbalance, inadequacy in individual coping, and lack of information were determined.

Keywords

Choledocholithiasis, ERCP, Nurse, Patient, Care, Case Report

Endoskopik Retrograd Kolanjiyo Pankreatografi (ERCP) Uygulanan Koledokolitiazis Hastası ve Hemşirelik Bakımı: Olgu Sunumu

Abstract

Koledokolitiazis, ortak safra kanalı içinde safra taşı varlığını ifade etmektedir. Yaşla birlikte fizyolojik olarak ortak safra kanalının genişlemesi nedeniyle koledokolitiazis, yaşlılarda daha sık görülmektedir. Koledokolitiazis genellikle biliyer kolik olarak tanımlanan karın ağrısına neden olmaktadır. Beraberinde bulantı ve kusma eşlik etmektedir. Koledokolitiazisli hastalarda Akut kolanjit, Akut Bilier Pankreatit gibi pek çok komplikasyon gelişebilmektedir. Komplikasyon gelişmiş koledokolitiazisli hastada hemşirelik bakımının amaçları; belirti ve bulguları erken tespit etmek, bireylerin öz bakımlarını sağlamak, yaşam kalitelerini yükseltmek ve iyilik hali kazandırmak, Endoskopik Retrograd Kolanjiyo Pankreatografi (ERCP) işlemi öncesinde, esnasında, sonrasında uygun hemşirelik girişimlerini planlamak, ERCP işlemi sırasında ve sonrasında gelişebilecek komplikasyonları takip etmek ve gerekli hemşirelik girişimlerini uygulamak, hasta ve ailesini eğitmektir. 56 yaşında olduğu bilinen ülseratif kolit (27 yıldır), ritim bozukluğu, DM tanıları olan hastanın 12 gündür epigastrik bölgede dolgunluk ve ağrısı nedeniyle acile başvurmuştur ve koledokolitiazis tanısı ile servise kabul edilmiştir. Olgu Marjory Gordon’un Fonksiyonel Sağlık Örüntüleri Hemşirelik Bakım Modeli ile değerlendirilerek, hemşirelik bakımı verilmiştir. Hastadan ve ailesinden çalışmanın yapılması ve yayınlanması için gerekli izin alınmıştır. Olguda akut ağrı, bulantı, hipertermi, iştahsızlığa bağlı vücut gereksiniminden az beslenme, yorgunluğa bağlı aktivite intoleransı, sarılık ve kaşıntıya bağlı cilt bütünlüğünde bozulma, sıvı elektrolit dengesizliği, bireysel başetmede yetersizlik, bilgi eksikliği hemşirelik tanıları belirlenmiştir.

Keywords

Koledokolitiazis, ERCP, Hemşire, Hasta, Bakım, Olgu Sunumu

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