NCLEX Question of the Day
Physiological Adaptation QID 1077
A patient is admitted with suspected acute cholecystitis. Which of the following signs would the nurse expect to find during a physical assessment?
Explanation
A positive Murphy's sign is the most specific finding for acute cholecystitis during a physical examination. Murphy's sign is elicited when the patient experiences increased pain and catches their breath when the examiner's hand is placed below the right costal margin as the patient takes a deep breath.
Rebound tenderness in the left lower quadrant is more indicative of conditions affecting the left side of the abdomen, such as diverticulitis, rather than cholecystitis, which typically causes pain in the right upper quadrant.
Pain that improves with eating is not characteristic of cholecystitis. In fact, cholecystitis pain often worsens after eating, especially fatty meals.
While jaundice can occur in some biliary conditions, it is not a typical early sign of acute cholecystitis. Jaundice is more commonly associated with conditions that obstruct the common bile duct, such as choledocholithiasis or pancreatic cancer.
Recognizing a positive Murphy's sign is crucial for nurses in the early identification of acute cholecystitis, allowing for prompt treatment and management.
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