The nurse is reviewing pathophysiology concepts to understand ...

[LCritchfi]

The nurse is reviewing pathophysiology concepts to understand what is occurring with an adult patient who has abdominal pain and a serum conjugated bilirubin level of 1.2 mg/dL. What should the nurse suspect is occurring with this patient?
 
  1. a disease that requires phototherapy
  2. a disorder that causes large amounts of red blood cell death
  3. a disorder of the biliary system
  4. a small bowel obstruction

Question 2

A patient with cholelithiasis has a serum amylase level of 300 units/L. What should the nurse consider as the most likely explanation for the laboratory finding?
 
  1. The gallstone is causing acute cholecystitis.
  2. The gallstone has migrated to the neck of the pancreas.
  3. The gallstone has caused bile to back into the pancreas.
  4. The gallstone is blocking the common bile duct.

[huda]

Answer to Question 1

Correct Answer: 3
Elevated direct (conjugated) bilirubin may indicate obstructed bile flow in the biliary duct system. The laboratory finding does not provide information to identify red blood cell death or small bowel obstruction. Phototherapy is used in the care of the newborn.

Answer to Question 2

Correct Answer: 4
When a gallstone in the bile duct blocks the common bile duct, pancreatic enzymes cannot exit the common bile duct and back up into the pancreas, causing pancreatitis, which elevates pancreatic enzymes. A normal serum amylase level is 0130 units/L. Acute cholecystitis does not elevate amylase levels. It would be highly unlikely for the gallstone to migrate to the neck of the pancreas. The gallstone does not cause bile to back into the pancreas, although it can cause pancreatic enzymes to back up into the pancreas.