4 Cholecystitis and Cholelithiasis Nursing Care Plans

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.