Case Study – CholecystitisObjectives
1. Explain the risk factors, symptoms, etiology, progression, diagnosis, treatment and
prognosis.
2. Demonstrate the ability to access and critically evaluate information from a wide
variety of sources (such as Library databases and internet sources).
Read the case presentation and answer the questions that follow. The Case Study
Rubric will be used to assess your work. The Case Study rubric lists the criteria for each
question (required resources, word counts and citation requirements).
Case Presentation
Kimberly, a forty year-old woman, presents to the emergency department complaining
of abdominal pain, nausea and vomiting. She has had similar episodes, but
spontaneously the pain would go away. Today the pain is more severe than in the past
and has lasted six hours. The pain is located in the right upper quadrant of her
abdomen and radiates to her right scapular region. She describes the pain as dull and
cramping. Kimberly’s vital signs are BP 148/96, HR 110, R 18, T 99.9 F.
On examination, Kimberly is overweight and is clutching her abdomen. Abdominal
examination reveals right upper quadrant abdominal tenderness and guarding.
Laboratory tests are ordered including a complete blood count (CBC), amylase, lipase,
urinalysis, urine Hcg and an ultrasound of the gallbladder.
Kimberly’s WBC is increased. The ultrasound of her gallbladder indicates gallbladder
wall thickening, distention and gallstones. There appears to be a gallstone in the
pancreatic duct, which concerns the
physician. She is diagnosed with
cholecystitis and cholelithiasis. Kimberly is
admitted to the hospital. She is given an
anti-emetic, medication for pain, and
antibiotics. The physician is consulting with
a surgeon to determine when the
gallbladder can be be removed via a
laparoscopic procedure.
Gallbladder with several pigmented gallstones.
[Digital image]. (n.d.). Retrieved from https://surgery4children.com/diagnoses-and-treatment/abdominal-disorders/gallstones/
Questions
1. Define the bold terms.
2. Describe the cause of cholecystitis.
3. This case presentation was fairly straight forward to the physician, though he
wanted to rule out other causes such as pregnancy. Another condition to
consider in patients with these signs and symptoms is a peptic ulcer.
Differentiate cholecystitis from peptic ulcer disease comparing the etiology, signs
and symptoms, diagnosis and treatment.
4. Kimberly is confused why she needs immediate surgery. Describe the following
in terms she can understand: the purpose of the gallbladder, why she can live
without the gallbladder, and the significance of a stone in the pancreatic duct.
5. Discuss post-operative/at home care instructions with Kimberly after the
laparoscopic removal of the gallbladder. Include in her post-operative care what
dietary changes she needs to consider.
Case Study Rubric
Criteria
3 points
Terminology N/A
2 points
1 point
0 points
All of the following criteria
are met:
Any of the following criteria Any of the following criteria
are met (all points must be are met:
met to advance to the next
All bold words are correctly level of achievement):
Answer does not
defined.
demonstrate accurate
All bold words are correctly knowledge of the
Accurately covered
defined.
terminology
required topic and required
No work submitted or
points using original
Topic covered accurately, contribution(s) do not
thought, not just the words but over-reliance on
comply with the principles
from sources.
sources, and not much
of academic honesty or
original thought.
other University policies
At least one professionalrelated to student conduct.
level source cited. Source AND/OR
is from the DU Library, text,
or a credible medical
Minor errors related to
dictionary.
accuracy.
APA formatting is used to
cite sources
At least one professionallevel source cited.
APA formatting is used to
cite sources
3 points
Cause
All of the following criteria
are met:
2 points
1 point
0 points
Any of the following criteria Any of the following criteria Any of the following criteria
are met (all points must be are met (all points must be are met:
met to advance to the next met to advance to the next
Accurately covered
level of achievement):
level of achievement):
Answer is incorrect or does
required topic and required
not demonstrate sufficient
points using original
Accurately covered
Topic covered accurately, depth of knowledge
thought, not just the words required topic and required but over-reliance on
from sources.
points using original
sources, and not much
No work submitted or
thought, not just the words original thought.
contribution(s) do not
Length at least 50 words
from sources
comply with the principles
Differential
Diagnosis
Minor error(s) related to
At least one peer-reviewed, Length at least 40 words
accuracy.
professional-level source
cited. Source is from the At least one peer-reviewed, No sources cited AND/OR
DU Library.
professional-level source
questionable source used.
cited.
APA formatting is used to
Errors in APA formatting
cite sources.
APA formatting is used to are present.
cite sources.
of academic honesty or
other University policies
related to student conduct.
3.5 to 4 points
0 to 1 points
2.5 to 3 points
1.5 to 2 points
.
All of the following points
Any of the following criteria Any of the following criteria Any of the following criteria
are covered accurately and are met (all points must be are met (all points must be are met:
in sufficient detail for
met to advance to the next met to advance to the next
diagnosed disease and
level of achievement):
level of achievement):
Answer is incorrect or does
disease to rule out:
not demonstrate sufficient
Cause/Etiology
Two or three of the
One of the following points depth of knowledge
Signs & Symptoms
following points are
is covered accurately and
Diagnosis
covered accurately and in in sufficient detail
No work submitted or
Treatment
sufficient detail for
diagnosed disease and
contribution(s) do not
diagnosed disease and
disease to rule out:
comply with the principles
Accurately covered
disease to rule out:
of academic honesty or
required topic and required
Cause/Etiology
other University policies
points using original
Cause/Etiology
Signs & Symptoms
related to student conduct.
thought, not just the words Signs & Symptoms
Diagnosis
from sources
Diagnosis
Treatment
Treatment
Length at least 200 words
Topic covered accurately,
Accurately covered
but over-reliance on
At least one peer-reviewed, required topic and required sources, and not much
professional-level source
points using original
original thought.
cited. Source is from the thought, not just the words
DU Library.
from sources
OR
APA formatting is used to
cite sources.
Length at least 150 words
Topic covered accurately,
but answer(s) are too short
At least one peer-reviewed, to demonstrate complete
professional-level source
knowledge.
cited.
APA formatting is used to
cite sources.
Length less than 100
words.
No sources cited AND/OR
questionable source used.
Errors in APA formatting
are present.
3 points
Patient
Education General
All of the following criteria
are met:
2 points
1 point
0 points
Any of the following criteria Any of the following criteria Any of the following criteria
are met(all points must be are met(all points must be are met:
met to advance to the next met to advance to the next
All of the following points
level of achievement):
level of achievement):
Answer is incorrect or does
are covered accurately and
not demonstrate sufficient
in sufficient detail:
Two or three of the
One of the following points depth of knowledge
:
following points are
is covered accurately and
At home care
covered accurately and in in sufficient detail:
No work submitted or
Over the counter
sufficient detail:
contribution(s) do not
medications
At home care
comply with the principles
Prescriptions (includes
At home care
Over the counter
of academic honesty or
pharmacological, therapy) Over the counter
medications
other University policies
Alternative or
medications
Prescriptions (includes
related to student conduct.
complementary care
Prescriptions (includes
pharmacological, therapy)
pharmacological, therapy) Alternative or
Accurately covered
Alternative or
complementary care
required topic and required complementary care
points using original
thought, not just the words Accurately covered
Topic covered accurately,
from sources
required topic and required but over-reliance on
Length at least 200 words points using original
sources, and not much
thought, not just the words original thought.
At least one peer-reviewed, from sources
professional-level source
OR
cited. Source is from the Length at least 150 words
DU Library.
Topic covered accurately,
At least one peer-reviewed, but answer(s) are too short
APA formatting is used to professional-level source
to demonstrate complete
cite sources.
cited.
knowledge.
APA formatting is used to
cite sources.
Length less than 100
words.
No sources cited AND/OR
questionable source used.
Errors in APA formatting
are present.
3 points
Patient
Education Prevention
and/or
Prognosis
2 points
1 point
All of the following criteria
are met:
0 points
Any of the following criteria Any of the following criteria Any of the following criteria
are met (all points must be are met (all points must be are met:
met to advance to the next met to advance to the next
Accurately covered
level of achievement):
level of achievement):
Answer is incorrect or does
required topic and required
not demonstrate sufficient
points using original
Accurately covered
Topic covered accurately, depth of knowledge
thought, not just the words required topic and required but over-reliance on
from sources
points using original
sources, and not much
No work submitted or
thought, not just the words original thought.
contribution(s) do not
Length at least 150 words from sources
comply with the principles
OR
of academic honesty or
APA formatting is used to APA formatting is used to
other University policies
cite sources.
cite sources.
Topic covered accurately, related to student conduct.
but answer(s) are too short
Length at least 100 words. to demonstrate complete
knowledge.
Length less than 75 words.
No sources cited AND/OR
questionable source used.
Errors in APA formatting
are present.