Helping Patients Cope with the Pain and Complications of Cholelithiasis and Cholecystitis
Last Revised: Nov 30, 2012
Contributed by: Karen Connick, RN, MSN, CGRN
Abstract
Cholecystitis and cholelithiasis are fairly common in the adult population. While cholelithiasis can be asymptomatic, the most common symptom of both diseases is biliary colic—severe pain in the right upper quadrant (RUQ) that typically radiates to the back and/or shoulders. Patients who are most likely to develop these conditions are older and female, use oral contraceptives or estrogen replacement therapy, or are obese. Complications include perforation of the gallbladder with subsequent peritonitis, obstruction of the biliary ducts resulting in hepatic complications and pancreatitis, sepsis, and abscess or fistula formation. The gold standard of treatment is a cholecystectomy generally performed laparoscopically. Medical treatment with dissolution of stones is also possible and is used for patients who have a high surgical risk or because of patient preference. Meticulous nursing assessment and care are imperative. Nurses who understand the disease process and nursing diagnoses associated with cholecystitis and cholelithiasis and who implement nursing interventions and patient teaching positively influence patient outcomes.
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