Gallbladder

Question 1

Factors that contribute to the development of gallbladder disease

Answer 1

1. Women
2. Obesity
3. Hyperlipidemia
4. Persons over 40 years
5. Biliary stasis
6. Native American
7. High calorie, cholesterol diet

Question 2

Strategies for prevention of gallbladder disease

Question 3

Assessment of a patient with gallbladder disease

Answer 3

Cholelithiasis:

1. Symptoms depend on whether stones are obstructing bile duct
2. If bile duct is blocked causes spasms or biliary colic
3. RUQ pain - can be referred to scapula
4. Pain 3-6 hours after heavy meal
5. Clay colored stools
6. Steatorrhea
7. Obstructive jaundice

Cholecystitis:

1. Vary from indigestion to moderate to severe pain, fever, jaundice
2. Pain and tenderness in RUQ which may be referred to as right shoulder and scapula
3. Restlessness
4. Diaphoresis
5. Nausea
6. Vomiting
7. Clay colored stools if inflammation causing obstruction

Question 4

Commonly occuring nursing diagnoses for the patient with gallbladder disease

Answer 4

• Acute pain r/t obstruction and inflammation
• Risk for infection r/t obstruction and decreased tissue perfusion
• Ineffective breathing pattern r/t surgical incision site located close to diaphragm (specific to incisional chole)

Question 5

Outcomes for a patient with actual/risk nursing diagoses related to gallbladder disease

Question 6

Nursing Interventions Post-op Incisional Cholecystectomy

Answer 6

• ABS’s, VS
• Prevention of respiratory complications
• General nursing post-op care
• If T-tube is present, provide T-tube care and assessment of bile drainage
• May have JP drain
• discharged within 2-3 days

Question 7

Identify the information to be included in a teaching plan for a paitent with gallbladder disease

Answer 7

Nutrition:

• Low fat recommended
• Weight reduction if necessary

Signs and Symptoms to Report:

• Bleeding
• Infection
• Uncontrolled Pain

Question 8

Identify foods to be included and excluded in the diet of a patient with gallbladder disease

Answer 8

Low fat recommended

Weight reduction is necessary

Question 9

Describe potential complications associated with gallbladder disease

Answer 9

• Bleeding
• Infection
• Uncontrolled pain

Question 10

What is the function of the gallbladder?

Answer 10

1. Small puch that sits under the liver
2. Stores bile produced by the liver
3. After meals, the gallbladder is empty and flat, like a deflated balloon
4. Before a meal, the gallbladder may be full of bile and about the size of a small pear
5. Squeezes stored bile into the small intestine through a series of tubes called ducts in response to signals
6. Bile helps digest fats but the gallbladder itself is not essential
7. Storage facility for the bile

Question 11

Cholelithiasis

Answer 11

• Gallstones
• Substances in bile can crystallize in the gallbladder, forming gallstones
• Common
• Usually harmless
• Sometimes can cause: pain, neusea, inflammation

Question 12

Cholecystitis

Answer 12

• Inflammation of the gallbladder
• Often due to a gallstone in the gallbladder
• Severe Pain
• Fever
• Can require surgery when inflammation continues or recurs

Question 13

Nursing interventions post-op for laparoscopic cholecystectomy

Answer 13

1. ABC’s, VS
2. CO2 referred pain assessment (retained CO2 irritates phrenic nerve and diaphragm: TNI: ambulation to dissipate the CO2)
3. Discharged home same day or within 24 hours