Summary disease process

Cholelithiasis (Gallbladder stones): common disorder of the binary system (stones in the
gallbladder)
Cholecystitis-inflammation of the gallbladder wall, usually associated with obstruction caused by
gallstones
or biliary sludge
Assessment:
 Biliary colic (severe pain)-excruciating pain accompanied by tachycardia, diaphoresis, and
prostration
 Dark urine
 RUQ pain/tenderness
Risk Factors:
 Multi parous women
 Women over 40yo/+
 Estrogen replacement therapy & oral contraceptive h risk
 Obesity
Dx: ultrasound
Planning: Relief of pain and discomfort, no complications, no recurrent attacks of cholecystitis
or gallstones
Interventions:
 IV fluids
 NPO with NG tube, later progressing to low fat diet
 Antiemetics, analgesics
 Fat soluble vitamins ADEK
 Anticholinergics (antispasmodics)-Atropine
 Antibiotics for secondary infection
 Biliary catheter
 Bile acids-ursodiol and chenodoil are used to dissolve stones
 Laparoscopic Cholecystectomy
Evaluation:
 Eat smaller, more frequent meals with some fat at each meal to promote gallbladder
emptying
 If obese, recommend reduced calorie diet
 Avoid rapid weight loss because it can promote gallstone formation