4 Cholecystitis and Cholelithiasis Nursing Care Plans

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, 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.

Cholelithiasisstones 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 the disease process, prognosis, and treatment.

Here are four (4) nursing care plans and nursing diagnoses for cholecystitis (cholelithiasis): 

  1. Risk for Deficient Fluid Volume
  2. Acute Pain
  3. Risk for Imbalanced Nutrition: Less Than Body Requirements
  4. Deficient Knowledge

Deficient Knowledge

Patients with cholecystitis and cholelithiasis may have deficient knowledge about the condition due to a lack of information or misinformation about the disease, misinterpretation of available information, and unfamiliarity with the medical terminology and concepts associated with the condition. This can lead to confusion, anxiety, and uncertainty about how to manage the condition and prevent future complications.

Nursing Diagnosis

  • Deficient Knowledge

May be related to

  • Lack of knowledge/recall
  • Information misinterpretation
  • Unfamiliarity with information resources

Possibly evidenced by

  • Questions; request for information
  • Statement of misconception
  • Inaccurate follow-through of instruction
  • Development of preventable complications

Desired Outcomes

  • The client will verbalize understanding of the disease process, prognosis, and potential complications.
  • The client will verbalize understanding of therapeutic needs.
  • The client will initiate necessary lifestyle changes and participate in the treatment regimen.

Nursing Assessment and Rationales

1. Review disease process and prognosis. Discuss hospitalization and prospective treatment as indicated. Encourage questions and expressions of concern.
Provides a knowledge base from which patients can make informed choices. Effective communication and support at this time can diminish anxiety and promote healing.

2. Review drug regimen, and possible side effects.
Gallstones often recur, necessitating long-term therapy. Development of diarrhea or cramps during chenodiol therapy may be dose-related or correctable. Note: Women of childbearing age should be counseled regarding birth control to prevent pregnancy and the risk of fetal hepatic damage.

3. Review signs and symptoms requiring medical intervention: recurrent fever; persistent nausea and vomiting, or pain; jaundice of skin or eyes, itching; dark urine; clay-colored stools; blood in urine, stools, vomitus; or bleeding from mucous membranes.
Indicative of the progression of the disease process and development of complications requiring further intervention.

Nursing Interventions and Rationales

1. Explain reasons for test procedures and preparations as needed.
Information can decrease anxiety, thereby reducing sympathetic stimulation.

2. Discuss weight reduction programs if indicated
Obesity is a risk factor associated with cholecystitis, and weight loss is beneficial in the medical management of chronic conditions.

3. Instruct patient to avoid food/fluids high in fats (pork, gravies, nuts, fried foods, butter, whole milk, ice cream), gas producers (cabbage, beans, onions, carbonated beverages), or gastric irritants ( spicy foods, caffeine, citrus).
Limits or prevents recurrence of gallbladder attacks.

4. Recommend resting in a semi-Fowler’s position after meals.
Promotes flow of bile and general relaxation during the initial digestive process.

5. Suggest the patient limit gum chewing, sucking on straws and hard candy, or smoking.
Promotes gas formation, which can increase gastric distension and discomfort.

6. Discuss avoidance of aspirin-containing products, forceful blowing of the nose, straining for bowel movement, and contact sports.
Reduces the risk of bleeding related to changes in coagulation time, mucosal irritation, and trauma.

7. Recommend the use of a soft toothbrush or electric razor.
Reduces the risk of bleeding related to changes in coagulation time, mucosal irritation, and trauma.

Recommended nursing diagnosis and nursing care plan books and resources.

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Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues, and on electrolytes and acid-base balance.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

More nursing care plans related to gastrointestinal disorders:

Matt Vera, a registered nurse since 2009, leverages his experiences as a former student struggling with complex nursing topics to help aspiring nurses as a full-time writer and editor for Nurseslabs, simplifying the learning process, breaking down complicated subjects, and finding innovative ways to assist students in reaching their full potential as future healthcare providers.

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