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CHOLELITHIASIS DIAGNOSIS:
 Also known as gallstone  ULTRASOUND

 formation of stones in the gallbladder or biliary

duct system.
2 TYPES:
1. Cholesterol – more common
2. Pigment – to be surgically removed.
HISTORY:

RISK FACTORS:
 Cystic fibrosis
 diabetes
 Gender (FEMALE – multiple pregnancy)
 Ethnicity
 Frequent change in weight (Obesity/RAPID
WEIGHT LOSS)
 Hyperinsulinemia
 Dyslipidemia

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 COMPUTED TOMOGRAPHY SCAN  EAT FEWER REFINED CARBOHYDRATE

AND LESS SUGAR
 AVOID SPICY FOODS AND SALTY FOOD

MEDICATION:
 Nsaids (diclofenac) – first-line therapy to
manage the pain of acute biliary colic or
complications of gallstones.
 Anticholinergics (Bentyl) – decrease the acid
production in the stomach that slows down the
natural gut movements, thus relaxing the
 MRI
muscles in several organs such as the stomach,
intestines, kidney, and bladder.
 Antibiotics (Ciprofloxin) – to protect against
sepsis and wound infection.
NURSING
RATIONALE
INTERVENTION NURSING CARE PLAN:
1. Acute pain related to inflammation of tissue
Independent:
-Monitor vital signs -Watch for situation
secondary to cholelithiasis

-Observe and document the -Assist in differentiating

location, severity (0-10), and
character of pain.
 
cause of pain and provides
information about the disease
progression or resolution,
development of complication
and effectiveness of
intervention.

-Response to medication - severe pain by routine

noted and physician measures may indicate
informed when pain is not developing complications or
relieved. needs further intervention.

-Bed rest in low Fowler’s

-Promote bed rest, allowing position reduces intra-
patient to assume position of abdominal pressures;
comfort however, patient will
  naturally assume least
painful position

DEPENDENT: -To relief pain

- Administer diclofenac as
ordered
 

2. Imbalance nutrition: Less than body

requirements related to dietary restriction
secondary to cholelithiasis
CHOL SCINTIGRAHY

 ENDOSCOPIC RETROGRADE

CHOLANGIOPANCREATOGRAPHY (ERCP)

DIET:
 HIGH- HEALTHY FATS like fish oil and olive
oil.
 INCREASED FLUID INTAKE

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NURSING
RATIONALE
INTERVENTION
-Assist patient in  -for education of the
demonstrating behavior, life patient for appropriate
style changes to regain recovery from nutritional
appropriate weight  imbalance
 
-Discuss eating habits -appeals client task and
including food preferences enhance intake
intolerance and aversion  
 
-promote pleasant relieving -this promotes comfort to
environment including the patient and encourages
socialization a good eating habit
   
-assess weight, measure or -establishes baseline
calculate body fat parameter
   
-evaluate total daily food -reveals possible cause of
intake malnutrition changes that
  could be made in client
intake
 
-encourage the patient to -stimulates the appetite of
choose food or have family client
member to bring food that  
seems appealing  
 
-weight at regular intervals -monitors effectiveness of
and document results dietary plan
 

3. Fluid volume deficit related to excessive loses

through vomiting secondary to cholelithiasis

NURSING
RATIONALE
INTERVENTION
INDEPENDENT:  
-monitor vital sign -it serves as baseline data
   
-encourage patient to -to prevent further
increase fluid intake dehydration
   
-weight patients daily -it can provide
  information in fluid
balance
-Encourage patient to bed  
rest -to promote calmness and
  comfort
 
DEPENDENT:  
-administer emeset as -to prevent and control
ordered by the physician nausea and vomiting
 
 

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PATHOPHYSIOLOGY:

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