Cholecystitis is the inflammation of the gallbladder, usually associated with gallstones impacted in the cystic duct. Stones (calculi) are made up of cholesterol, calcium bilirubinate, or a mixture caused by changes in the bile composition. Gallstones can develop in the common bile duct, the cystic duct, hepatic duct, small bile duct, and pancreatic duct. Crystals can also form in the submucosa of the gallbladder causing widespread inflammation. Acute cholecystitis with cholelithiasis is usually treated by surgery, although several other treatment methods (fragmentation and dissolution of stones) are now being used.
Choleslithiasis, stones or calculi in the gallbladder, results from changes in bile components. Gallstones are made of cholesterol, calcium bilirubinate, or a mix of cholesterol and bilirubin. They arise during periods of sluggishness in the gallbladder due to pregnancy, hormonal contraceptives, diabetes mellitus, celiac disease, cirrhosis of the liver, and pancreatitis.
Nursing Care Plans
Nursing care planning and management for patients with cholecystitis include relieving pain and promoting rest, maintaining fluid and electrolyte balance, preventing complications, and provision of information about disease process, prognosis, and treatment.
Here are four (4) nursing care plans for cholecystitis (cholelithiasis):
- Risk for Deficient Fluid Volume
- Acute Pain
- Risk for Imbalanced Nutrition: Less Than Body Requirements
- Deficient Knowledge
Risk for Deficient Fluid Volume
Risk for Deficient Fluid Volume: At risk for experiencing vascular, cellular, or intracellular dehydration.
Risk factors may include
- Excessive losses through gastric suction; vomiting, distension, and gastric hypermotility
- Medically restricted intake
- Altered clotting process
Possibly evidenced by
- Not applicable. A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occurred and nursing interventions are directed at prevention.
- Demonstrate adequate fluid balance evidenced by stable vital signs, moist mucous membranes, good skin turgor, capillary refill, individually appropriate urinary output, absence of vomiting.
|Maintain accurate record of I&O, noting output less than intake, increased urine specific gravity. Assess skin and mucous membranes, peripheral pulses, and capillary refill.||To provide information about fluid status and circulating volume needing replacement.|
|Monitor for signs and symptoms of increased or continued nausea or vomiting, abdominal cramps, weakness, twitching, seizures, irregular heart rate, paresthesia, hypoactive or absent bowel sounds, depressed respirations.||Prolonged vomiting, gastric aspiration, and restricted oral intake can lead to deficits in sodium, potassium, and chloride.|
|Eliminate noxious sights or smells from environment.||Reduces stimulation of vomiting center.|
|Perform frequent oral hygiene with alcohol-free mouthwash; apply lubricants.||Decreases dryness of oral mucous membranes; reduces risk of oral bleeding.|
|Use small-gauge needles for injections and apply firm pressure for longer than usual after venipuncture.||Reduces trauma, risk of bleeding or hematoma formation.|
|Assess for unusual bleeding: oozing from injection sites, epistaxis, bleeding gums, ecchymosis, petechiae, hematemesis or melena.||Prothrombin is reduced and coagulation time prolonged when bile flow is obstructed, increasing risk of bleeding or hemorrhage.|
|Keep patient NPO as necessary.||Decreases GI secretions and motility.|
|Insert NG tube, connect to suction, and maintain patency as indicated.||To rest the GI Tract|
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Gastrointestinal Care Plans
Care plans covering the disorders of the gastrointestinal and digestive system:
- Appendectomy | 4 Care Plans
- Cholecystectomy | 12 Care Plans
- Cholecystitis and Cholelithiasis | 4 Care Plans
- Gastroenteritis | 4 Care Plans
- Hemorrhoids | 3 Care Plans
- Hepatitis | 7 Care Plans
- Ileostomy & Colostomy | 10 Care Plans
- Inflammatory Bowel Disease | 7 Care Plans
- Intussusception | 3 Care Plans
- Liver Cirrhosis | 8 Care Plans
- Pancreatitis | 8+ Care Plans
- Peritonitis | 6 Care Plans
- Peptic Ulcer Disease | 5 Care Plans
- Subtotal Gastrectomy | 2 Care Plans
Recommended books and resources:
- Nursing Care Plans: Diagnoses, Interventions, and Outcomes
- Nurse's Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
- Nursing Diagnoses 2015-17: Definitions and Classification
- Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR)
- Manual of Psychiatric Nursing Care Planning
- Maternal Newborn Nursing Care Plans
- Delmar's Maternal-Infant Nursing Care Plans, 2nd Edition
- Maternal Newborn Nursing Care Plans