Gallbladder Flashcards
Factors that contribute to the development of gallbladder disease
- Women
- Obesity
- Hyperlipidemia
- Persons over 40 years
- Biliary stasis
- Native American
- High calorie, cholesterol diet
Strategies for prevention of gallbladder disease
Assessment of a patient with gallbladder disease
Cholelithiasis:
- Symptoms depend on whether stones are obstructing bile duct
- If bile duct is blocked causes spasms or biliary colic
- RUQ pain - can be referred to scapula
- Pain 3-6 hours after heavy meal
- Clay colored stools
- Steatorrhea
- Obstructive jaundice
Cholecystitis:
- Vary from indigestion to moderate to severe pain, fever, jaundice
- Pain and tenderness in RUQ which may be referred to as right shoulder and scapula
- Restlessness
- Diaphoresis
- Nausea
- Vomiting
- Clay colored stools if inflammation causing obstruction
Commonly occuring nursing diagnoses for the patient with gallbladder disease
- Acute pain r/t obstruction and inflammation
- Risk for infection r/t obstruction and decreased tissue perfusion
- Ineffective breathing pattern r/t surgical incision site located close to diaphragm (specific to incisional chole)
Outcomes for a patient with actual/risk nursing diagoses related to gallbladder disease
Nursing Interventions Post-op Incisional Cholecystectomy
- ABS’s, VS
- Prevention of respiratory complications
- General nursing post-op care
- If T-tube is present, provide T-tube care and assessment of bile drainage
- May have JP drain
- discharged within 2-3 days
Identify the information to be included in a teaching plan for a paitent with gallbladder disease
Nutrition:
- Low fat recommended
- Weight reduction if necessary
Signs and Symptoms to Report:
- Bleeding
- Infection
- Uncontrolled Pain
Identify foods to be included and excluded in the diet of a patient with gallbladder disease
Low fat recommended
Weight reduction is necessary
Describe potential complications associated with gallbladder disease
- Bleeding
- Infection
- Uncontrolled pain
What is the function of the gallbladder?
- Small puch that sits under the liver
- Stores bile produced by the liver
- After meals, the gallbladder is empty and flat, like a deflated balloon
- Before a meal, the gallbladder may be full of bile and about the size of a small pear
- Squeezes stored bile into the small intestine through a series of tubes called ducts in response to signals
- Bile helps digest fats but the gallbladder itself is not essential
- Storage facility for the bile
Cholelithiasis
- Gallstones
- Substances in bile can crystallize in the gallbladder, forming gallstones
- Common
- Usually harmless
- Sometimes can cause: pain, neusea, inflammation
Cholecystitis
- Inflammation of the gallbladder
- Often due to a gallstone in the gallbladder
- Severe Pain
- Fever
- Can require surgery when inflammation continues or recurs
Nursing interventions post-op for laparoscopic cholecystectomy
- ABC’s, VS
- CO2 referred pain assessment (retained CO2 irritates phrenic nerve and diaphragm: TNI: ambulation to dissipate the CO2)
- Discharged home same day or within 24 hours
