23/06/2026
SURGERY-NMCZ-EXAM QUESTION
Mrs. Mwambazi Munene a 42 years old woman weighs 94 Kg. She is admitted to your ward with complaints of abdominal pain in the right upper quadrant. A diagnosis of acute cholecystitis is made and he is scheduled to undergo cholecystectomy.
a. i. Define cholecystectomy 5%
ii. Draw a well labelled diagram of the biliary tree and show the direction of bile flow. 10%
b. State five (5) clinical features that Munene may present with 15%
c. Discuss the postoperative care you would provide to Mrs. MuneneUntil discharge. 50%
d. State four (4) functions of the liver. 20%
ANSWERS TO THE ABOVE Q
a). i) Cholecystectomy: This is the surgical removal of the gall bladder due to the presence of choleliths, or gallstones, in the gallbladder or inflammation.
ii) will be posted or find on the commenting block
b). State five (5) clinical features that Mr Munene may present with.
1. Colic pain that starts suddenly and persists for 1-4 hours due to inflammatory process
2. Aching pain with sensation of pressure in the epigastric region due to inflammatory
3. Nausea and vomiting due to involvement of the GIT
4. Low –grade fever due the inflammatory process
5. Jaundice due to obstructive
6. Right upper Quadrant guarding due to pain
7. Inability to take deep inspiration when examining finger are pressing below
the hepatic margin.
c.) Post operative care in the first 48 hours
Objectives
1. To return the physiological function back to normal as early as possible.
2. To promote wound healing.
3. To prevent complications
ENVIRONMENT
I will ensure that post- operative equipment’s and tray is available for immediate access in case of the need for resuscitation.
I will nurse the patient in a well ventilated and clean to ensure a soothing environment and to prevent cross infection
I will nurse the patient in quiet environment to promote rest
POSITION
I will nurse the patient in low – fowler’s one side to allow e
