CASE STUDY:

Cholelithiasis
Prepared By:
Paulin, Rose Anne
Ramos, Jackie
Ruaza, Michael
San Miguel, Elena
Santiago, Aizelle
INTRODUCTION
GOAL:
• To present a comprehensive study on cholelithiasis in order to enhance
the knowledge and develop the skills and attitudes of student nurses in
the actual care and management of patients suffering from this disease.

OBJECTIVES:
• Discuss the pathophysiology, incidence / prevalence, and mortality / morbidity
associated with the disease being reviewed, along with the race, sex, and age
range of persons typically affected;
• Recognize the typical clinical presentation, including common symptoms and
physical examination findings;
• To formulate a comprehensive nursing care plan utilizing the nursing process.
• Administer proper medical/surgical care and recommend appropriate
consultations, diets, and activities;
• List categories of medications useful in treatment and demonstrate familiarity with
dosage regimens of appropriate medications;
• Provide suitable follow-up care;
• Institute prevention strategies for developing further complications;
• Discuss potential complications and prognosis; and
• To provide a continuous home care through the discharge plan.
NURSING
HEALTH
HISTORY
 PHYSICAL
ASSESSMENT
 ANATOMY
and
PHYSIOLOGY
 PATHO-
PHYSIOLOGY
DIAGNOSTIC
PROCEDURES
and
LABORATORY
RESULTS
NURSING
CARE
PLAN
• Readiness for enhanced
knowledge related to
preoperative preparation
• Risk for infection related
to abdominal incision
• Risk for pain/discomfort
related to abdominal
incision.
DRUG
STUDY
• CEFUROXIME
• OMEPRAZOLE
• PARACETAMOL
• HYOSCYAMINE BUTYLBROMIDE
• METFORMIN HCL
• CEFTAZIDIME
• MEPERIDINE HCL
• INSULIN GLARGINE
• NPH INSULIN
DISCHARGE
PLAN
M – MEDICINE
• Advise the patient and the significant others to comply strictly with the
prescribed medications in order to aid in the recovery state after
surgery.
• Discuss with the patient the things she needs to know about her
medications. (e.g., side effects, adverse reactions)

E – ENVIRONMENT AND EXERCISE

• Maintain a quiet, pleasant, environment to promote relaxation.
• Provide clean and comfortable environment.
• Advise the patient to perform exercises within physical limits and to
avoid fatigue by planning rest periods during the day.
• Instruct the patient to breathe deeply and slowly during the periods of
an activity.
• Strenuous exercise and lifting should be avoided.

T – TREATMENT
• Instruct patient to comply with the home medications that would be
given by his physician.
• Teach patient about wound care.
• Encourage rest, relaxation and proper nutrition.
H – HEALTH TEACHING
• Instruct patients to avoid emotional stress.
• Provide written and oral instructions about wound care, activity, diet
recommendations, and medications.
• Teach patient about caring for the stitches, hygiene and bathing.
• Encourage patient to do the recommended light exercises such as
walking. Avoid doing strenuous activities which could slow down
his recovery.
• Encourage him to comply with the dietary modifications; limit the
intake of saturated fat to prevent the occurrence of serious post-
cholecystectomy side-effects.
• Explain to patient to refer for untoward signs and symptoms
immediately.
O – OUT PATIENT FOLLOW-UP
• Instruct the patient to consult the physician for any problems or
complications encountered.
• Remind patient that regular check-ups are important to ensure that
the patient condition is constantly monitored by the doctor.
D – DIET
• Advise patient to limit the intake of saturated fat and
that she should eat smaller amounts of food during a
single meal.
• Eat three balanced meals a day; high in fiber, low in
saturated fats.
• Direct irritants such as spices, red and black peppers
should be limited.
S – SPIRITUALITY
• Encourage patient to communicate with God.
• Encourage patient to communicate with other people.
 THE END

Thank you for listening!