Materiały źródłowe

• #1 Acute Cholecystitis – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis

  Acute cholecystitis is inflammation of the gallbladder that develops over hours, usually because a gallstone obstructs the cystic duct. Symptoms include right upper quadrant pain and tenderness, sometimes accompanied by fever, chills, nausea, and vomiting. Treatment usually involves antibiotics and cholecystectomy. […] Management includes hospital admission, IV fluids, and analgesics, such as a nonsteroidal anti-inflammatory drug (NSAID; ketorolac) or opioid. Nothing is given orally, and nasogastric suction is instituted if vomiting or an ileus is present. Parenteral antibiotics are usually initiated to treat possible infection, but evidence of benefit is lacking. Empiric coverage, directed at gram-negative enteric organisms, involves IV regimens such as ceftriaxone plus metronidazole, piperacillin/tazobactam, or ticarcillin/clavulanate. […] Treat patients with IV fluids, antibiotics, and analgesics; do cholecystectomy when patients are stable.

• #2 Treatment of acute calculous cholecystitis – UpToDate

  https://www.uptodate.com/contents/treatment-of-acute-calculous-cholecystitis

  Acute cholecystitis is a syndrome of right upper quadrant pain, fever, and leukocytosis associated with gallbladder inflammation. It typically occurs in patients with gallstones (ie, acute calculous cholecystitis [ACC]), while acalculous cholecystitis accounts for a minority (5 to 10 percent) of cases. Complications of acute cholecystitis include gallbladder gangrene or perforation, which can be life-threatening. […] Patients with ACC usually present with severe and steady abdominal pain in the right upper quadrant or epigastrium, fever, and leukocytosis. A positive Murphy’s sign on physical examination supports the diagnosis. In most cases, the diagnosis can be established with an abdominal ultrasound or a cholescintigraphy if the ultrasound is equivocal. […] Cholecystectomy is the mainstay of treatment for ACC. Poor surgical candidates may benefit from initial nonoperative management with antibiotics and a gallbladder drainage procedure; those whose surgical risk improves after resolution of the acute inflammation should undergo elective gallbladder surgery to prevent recurrent symptoms.

• #3 Treatment of acute calculous cholecystitis – UpToDate

  https://www.uptodate.com/contents/treatment-of-acute-calculous-cholecystitis

  Acute cholecystitis is a syndrome of right upper quadrant pain, fever, and leukocytosis associated with gallbladder inflammation. It typically occurs in patients with gallstones (ie, acute calculous cholecystitis [ACC]), while acalculous cholecystitis accounts for a minority (5 to 10 percent) of cases. Complications of acute cholecystitis include gallbladder gangrene or perforation, which can be life-threatening. […] Patients with ACC usually present with severe and steady abdominal pain in the right upper quadrant or epigastrium, fever, and leukocytosis. A positive Murphy’s sign on physical examination supports the diagnosis. In most cases, the diagnosis can be established with an abdominal ultrasound or a cholescintigraphy if the ultrasound is equivocal. […] Cholecystectomy is the mainstay of treatment for ACC. Poor surgical candidates may benefit from initial nonoperative management with antibiotics and a gallbladder drainage procedure; those whose surgical risk improves after resolution of the acute inflammation should undergo elective gallbladder surgery to prevent recurrent symptoms.

• #4 Acute cholecystitis – Management recommendations | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000084/management-recommendations

  Gallbladder empyema is the most severe form of acute cholecystitis. […] Reconsider laparoscopic cholecystectomy for people who have had percutaneous cholecystostomy once they are well enough for surgery. […] Gangrene occurs most commonly at the fundus due to a compromised vascular supply. […] Have a low threshold for conversion to open cholecystectomy during the procedure. […] Perforation may require percutaneous drainage of the resulting collection or expedited surgery. […] After the gallbladder has perforated, patients may experience transient relief of their symptoms because the gallbladder decompresses, but peritonitis then develops. […] About 90% of patients with acute cholecystitis have gallstones. […] Manage any precipitating infections. […] Optimise any contributing factors in critically ill patients, such as those fasting or receiving total parenteral nutrition.

• #5 Gallstones and Cholecystitis | Doctor

  https://patient.info/doctor/gallstones-and-cholecystitis

  Acute cholecystitis is an inflammation of the gallbladder. It usually occurs when a gallstone completely obstructs the gallbladder neck or cystic duct. Gallstones account for 90-95% of cases of acute cholecystitis. Obstruction of the gallbladder neck or cystic duct by a gallstone causes bile to become trapped in the gallbladder, resulting in irritation and increased pressure in the gallbladder. […] If acute cholecystitis is suspected, admit the person to hospital for: confirmation of the diagnosis, including abdominal ultrasound and blood tests (including white blood cell count, C-reactive protein, and serum amylase). Monitoring, including blood pressure, pulse, and urinary output. Treatment may include intravenous fluids, antibiotics, and analgesia. Surgical assessment for cholecystectomy.

• #6 Cholelithiasis and Cholecystitis Nursing Care Plan & Management

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/cholelithiasis-and-cholecystitis-nursing-management/

  Cholecystitis is acute or chronic inflammation of the gallbladder. […] Acute cholecystitis may be calculous (with gallstones) or acalculous (without gallstones). […] In acute and chronic cholecystitis, inflammation causes the gallbladder wall to become thickened and edematous and causes the cystic lumen to increase in diameter. […] Biliary colic is a symptom of acute cholecystitis. […] Tenderness and rigidity in the right upper quadrant elicited on palpation (i.e. Murphy’s sign) is another clinical manifestation. […] Nursing interventions during an acute gallbladder attack include intervening to relieve pain and administering prescribed analgesics. […] Administer IV fluids, monitor intake and output, and provide adequate nutrition by encouraging a high-protein, high-carbohydrate, low-fat diet.

• #7

  https://www.laparoscopyhospital.com/forum/forum.php?p=&cat_id=&tid=3537

  Acute cholecystitis, if left untreated or not managed properly, can lead to several potential complications, including: Gangrene: Severe inflammation can reduce blood flow to the gallbladder, leading to tissue death (gangrene) in the gallbladder. Perforation: Inflammation and pressure buildup can cause the gallbladder to rupture, leading to bile leakage and potentially life-threatening infections in the abdominal cavity (peritonitis). Abscess formation: Pus-filled pockets (abscesses) can develop in the gallbladder or surrounding tissues due to infection. Bile duct obstruction: Inflammation can cause the gallbladder or bile ducts to become blocked, leading to jaundice (yellowing of the skin and eyes) and potentially severe liver problems. Pancreatitis: Inflammation in the pancreas can occur due to blockage of the pancreatic duct by gallstones or inflammation spreading from the gallbladder. Chronic cholecystitis: Repeated episodes of acute cholecystitis can lead to chronic inflammation of the gallbladder, which can cause ongoing pain and digestive problems. Gallbladder cancer: Although rare, chronic inflammation and gallstones can increase the risk of developing gallbladder cancer over time. Sepsis: In severe cases, untreated acute cholecystitis can lead to a systemic infection (sepsis), which can be life-threatening if not promptly treated.

• #8 A nurse is caring for a client with acute cholecystitis. | Nursing Exam

  https://www.naxlex.com/nursing/question/a-nurse-is-caring-for-a-client-with-acute-cholecystitis-which-of-the

  A nurse is caring for a client with acute cholecystitis. Which of the following clinical manifestations is most commonly associated with this condition? […] Severe, colicky abdominal pain radiating to the right shoulder is the most common presentation of acute cholecystitis, often caused by gallbladder inflammation and obstruction of the cystic duct. […] Cholecystitis with cholangitis is characterized by severe right upper quadrant abdominal pain, fever, and jaundice.

• #9 Cholecystitis, Acute | Time of Care

  https://www.timeofcare.com/cholecystitis/

  Pt c/o of RUQ / epigastric abdominal pain. Pain radiates to R shoulder/back. Pain is steady and severed. Associated symptoms include fever, nausea, vomiting, anorexia. There was a history of fatty food ingestion one hour or more before the initial onset of pain. The episodes of pain are typically prolonged (greater than four to six hours). […] Pt is ill appearing, febrile, and tachycardic, and lie still on the examining table (because cholecystitis is associated with true local parietal peritoneal inflammation that is aggravated by movement.) […] Treatment: NPO, IV fluids, NGT if intractable vomiting, analgesia Zofran for Nausea Pain management IV Antibiotics Zosyn (Pip-Tazo) to cover for Anaerobes + Gram Negatives (GNR). […] Consult surgery for early cholecystectomy (usually w/in 72 h).

• #10 Acute Cholecystitis Symptoms and Nursing Management of Gall Bladder Attacks | Health And Willness

  https://healthandwillness.org/acute-cholecystitis-and-gall-bladder-attacks/

  Acute Cholecystitis is the most common complication of gallstones. As the suffix -itis suggests, this is when there is acute inflammation of the gallbladder – often from a blocked stone or duct. This can lead to pain, infection, abnormal labs, and a need of surgical removal. […] The nursing assessment should pay close attention to GI symptoms, and really focus on the abdominal assessment. […] Symptoms of acute cholecystitis include: RUQ Abdominal Pain. The gallbladder Is located in the right upper quadrant – and this is the area that typically hurts when there is a gall bladder attack and especially during acute cholecystitis. The pain is said to be intense but dull. […] The abdominal assessment is key with cholecystitis. The patient will often have RUQ tenderness with possible guarding. They may also have hypoactive bowel sounds – this is because the inflammation and irritation in the gallbladder can affect nearby digestive organs, leading to a decreased motility and function of the intestines.

• #11 Cholecystitis NCLEX Questions

  https://www.registerednursern.com/cholecystitis-nclex-questions/

  This is a quiz that contains NCLEX review questions for cholecystitis. As a nurse providing care to a patient with cholecystits, it is important to know the classic signs and symptoms of this conditions, diagnostic tests, and nursing care. […] A patient is being transferred to your unit with acute cholecystitis. In report the transferring nurse tells you that the patient has a positive Murphys Sign. You know that this means: A. The patient stops breathing in when the examiner palpates under the ribs on the right upper side of the abdomen at the midclavicular line. […] Your patient is post-op day 3 from a cholecystectomy due to cholecystitis and has a T-Tube. Which finding during your assessment of the T-Tube requires immediate nursing intervention? […] Your recent admission has acute cholecystitis. The patient is awaiting a cholecystostomy. What signs and symptoms are associated with this condition? Select all that apply: A. Right lower quadrant pain with rebound tenderness

• #12 Acute cholecystitis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000084

  Acute cholecystitis is a major complication of cholelithiasis (i.e., gallstones); symptomatic gallstones are common before developing cholecystitis. […] Patients typically present with pain and localised tenderness, with or without guarding, in the upper right quadrant. […] There may be evidence of a systemic inflammatory response with fever, elevated white cell count, and raised C-reactive protein. […] Treatment is with antibiotics, analgesia, and fluid resuscitation as required, likely to be followed by an early cholecystectomy.

• #13 Nursing Care Plan for Cholecystitis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-cholecystitis-2

  AST/ALT may be elevated due to liver dysfunction in cases of obstruction […] Elevated bilirubin may indicate common bile duct obstruction/liver dysfunction […] Urinalysis- can be used to rule out pyelonephritis and renal calculi as source of pain […] Pregnancy test should be done on all women of childbearing age to prevent fetal demise […] Imaging: Ultrasound is the diagnostic choice as it allows visualization of acute disease without excessive radiation exposure […] Prepare patient for diagnostic procedures: […] ERCP (Endoscopic Retrograde Cholangiopancreatography) allows visualization of the biliary system to help diagnose and treat problems with the bile and pancreatic ducts. […] HIDA scan (Hepatobiliary Iminodiacetic Acid)- performed by injecting a radioactive dye into the bloodstream and visualizing the flow through a special camera placed on the abdomen

• #14 Role of POCUS in Diagnosing Acute Cholecystitis and its Life-Threatening Complications | Point-of-Care Ultrasound Certification Academy

  https://www.pocus.org/role-of-pocus-in-diagnosing-acute-cholecystitis-and-its-life-threatening-complications/

  Ultrasound findings of acute cholecystitis may include: Gallbladder wall thickening, Distended gallbladder, Pericholecystic fluid (seen as an anechoic rim around the gallbladder), A positive sonographic Murphy sign. […] Acute cholecystitis can be managed conservatively initially with antibiotics and intravenous fluids with a plan to perform an elective cholecystectomy after a few weeks. However, 2-30% of patients may develop gangrenous cholecystitis. This condition is life-threatening and is considered a surgical emergency. It must be verified on ultrasound. […] In conclusion, the physical exam alone is not sensitive enough to diagnose gangrenous cholecystitis. A negative Murphy sign on a physical exam could be seen in the absence of acute cholecystitis or in the presence of gangrenous cholecystitis. Point-of-care ultrasound (POCUS) must be used to rule out this potentially life-threatening condition. […] The rapid adoption and use of POCUS by clinicians globally will help diagnose life-threatening complications of acute cholecystitis leading to immediate surgical intervention and lower mortality rates associated with these complications.

• #15 Cholecystitis Nursing Care Management and Study Guide

  https://nurseslabs.com/cholecystitis/

  Cholecystitis is the acute or chronic inflammation of the gallbladder. […] Management of cholecystitis include the following: […] The major goals for the patient include: relieve pain and promote rest, maintain fluid and electrolyte balance, prevent complications, provide information about disease process, prognosis, and treatment needs. […] Treatment of cholecystitis depends on the severity of the condition and the presence or absence of complications. […] Expected patient outcomes are: pain relieved, homeostasis achieved, complications prevented/minimized, disease process, prognosis, and therapeutic regimen understood. […] The focus of discharge instructions for patients with cholecystitis is education. […] Patients with cholecystitis must be educated regarding causes of their disease, complications if left untreated, and medical and surgical options.

• #16 Cholecystitis ppt | PPT

  https://www.slideshare.net/slideshow/cholecystitis-ppt/225575178

  Nursing Management: Management of cholecystitis include the following: Nursing Assessment: Integumentary system. Assess skin and mucous membranes. Circulatory system. Assess peripheral pulses and capillary refill. […] Nursing Diagnosis 1. Nursing Diagnosis Acute Pain related to: biological trauma obstruction / spasm tract inflammatory processes, ischemia / tissue necrosis Evidenced by: Complaints of pain, colic biliary (pain frequency). […] Nursing Goals The major goals for the patient include: Relieve pain and promote rest. Maintain fluid and electrolyte balance. Maintain nutritional balance. Provide information about disease process, prognosis, and treatment needs. […] Nursing Intervention: 1. Relieve pain and promote rest Observe and document location, severity [0-10], and character of pain [steady, intermittent, colicky]. Note response to medication, and report to physician if pain is not being relieved.

• #17 Acute Cholecystitis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568804/

  After reading this article you will be able to: […] Recall the nursing diagnosis of acute cholecystitis. […] Acute Cholecystitis. […] Anxiety-related to surgical intervention. […] Acute Pain related to the disease process. […] Anorexia related to nausea and bloating. […] The risk of deficient fluid volume. […] The risk for imbalanced nutrition: less than body requirement. […] Assess the vital signs frequently and inform the doctor if there is any abnormality. […] Assess abdominal pain through physical examination, nausea, and vomiting. […] Start IV fluid and pain medications as prescribed. […] Prepare the patient for the operative room by keeping him NPO, teach the patient about the procedure steps, and about the postoperative management. […] Place the patient in a semi-fowlers position.

• #18 11.6 Cholecystitis – Health Alterations

  https://wtcs.pressbooks.pub/healthalts/chapter/11-6-cholecystitis/

  Cholecystitis is inflammation of the gallbladder due to impaired flow of bile due to blockage by gallstones or a poorly functioning gallbladder. […] Nursing priorities for those suffering from cholecystitis include managing pain, preparing the client for surgery if indicated, and ensuring optimal nutrition. […] Nursing diagnoses for clients with cholecystitis are created based on the specific needs of the client, their signs and symptoms, and the etiology of the disorder. […] Possible nursing diagnoses for those with cholecystitis are as follows: Acute Pain, Anxiety, Deficient Fluid Volume, Imbalanced Nutrition: Less than Body Requirements. […] For the client with cholecystitis, the following nursing interventions can be divided into nursing assessments, nursing actions, and client teaching.

• #19 Nursing Care Plan for Cholecystitis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-cholecystitis-2

  Cholecystitis Nursing Care Plan […] Patient will be free of pain and resume and maintain optimal diet and nutrition. […] Assess vital signs […] Monitor for signs of cardiopulmonary stress and signs of infection […] Assess Gastrointestinal status […] Look for distention […] Listen for frequent belching […] Feel for abdominal rigidity and palpable gallbladder, note tenderness […] Initiate IV access and administer fluids […] IV access will be required for medication administration and for anesthesia if surgery or diagnostic procedures are being performed. Patient will need to be on bowel rest program and IV hydration is essential. […] Assess and manage pain […] Severe pain is the most common and worrisome symptom. Patients may report pain that radiates from the RUQ to the back

• #20 Acute Cholecystitis Symptoms and Nursing Management of Gall Bladder Attacks | Health And Willness

  https://healthandwillness.org/acute-cholecystitis-and-gall-bladder-attacks/

  Acute Cholecystitis is the most common complication of gallstones. As the suffix -itis suggests, this is when there is acute inflammation of the gallbladder – often from a blocked stone or duct. This can lead to pain, infection, abnormal labs, and a need of surgical removal. […] The nursing assessment should pay close attention to GI symptoms, and really focus on the abdominal assessment. […] Symptoms of acute cholecystitis include: RUQ Abdominal Pain. The gallbladder Is located in the right upper quadrant – and this is the area that typically hurts when there is a gall bladder attack and especially during acute cholecystitis. The pain is said to be intense but dull. […] The abdominal assessment is key with cholecystitis. The patient will often have RUQ tenderness with possible guarding. They may also have hypoactive bowel sounds – this is because the inflammation and irritation in the gallbladder can affect nearby digestive organs, leading to a decreased motility and function of the intestines.

• #21 Cholelithiasis Nursing Interventions & Care Plan

  https://www.picmonic.com/pathways/nursing/courses/standard/medical-surgical-nursing-pathophysiology-296/biliary-disorders-1423/cholecystitis-interventions_2200

  Pain management using analgesics is critical during an acute episode of cholecystitis. […] If the patient’s cholecystitis is caused by the formation of gallstones, lithotripsy may be indicated. […] A cholecystectomy is the surgical removal of the gallbladder. […] After gallbladder surgery, a T tube may be inserted into the common bile duct. The T tube allows excess bile to drain as the small intestines adjust to receiving continuous bile flow.

• #22 Cholecystitis Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/cholecystitis-nursing-diagnosis/

  Cholecystitis is an inflammation of the gallbladder that often results from gallstones blocking the cystic duct. This condition requires careful nursing assessment and management to prevent complications and ensure optimal patient outcomes. […] Successful management of cholecystitis includes: Pain reduction within 24-48 hours, Normal vital signs, Improved appetite, Prevention of complications, Understanding of dietary modifications, Successful recovery from surgery (if performed), Return to normal activities within the prescribed timeframe. […] Nursing Diagnosis Statement: Acute Pain related to inflammation of the gallbladder and tissue distension as evidenced by right upper quadrant pain, guarding behavior, and verbal pain rating of 7/10. […] Nursing Interventions and Rationales: Assess pain characteristics regularly Rationale: Enables proper pain management and monitors disease progression. Administer prescribed pain medications Rationale: Reduces pain and inflammation. Position patient for comfort Rationale: Minimizes tension in the affected area. Monitor pain relief effectiveness Rationale: Ensures adequate pain management.

• #23 4 Cholecystitis and Cholelithiasis Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cholecystitis-cholelithiasis-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. […] Patients with cholecystitis and cholelithiasis are at risk for deficient fluid volume due to excessive losses resulting from vomiting or diarrhea, limited intake due to nausea and anorexia, and altered clotting processes due to liver dysfunction. This can lead to dehydration and impaired perfusion, which can worsen the inflammatory response associated with these conditions and potentially lead to systemic complications. […] Nursing care plans for patients with cholecystitis and cholelithiasis may include interventions to manage acute pain, address nutritional imbalances, and provide education to enhance understanding of the condition and its management.

• #24 Cholecystitis NCLEX Questions

  https://www.registerednursern.com/cholecystitis-nclex-questions/

  Your patient is diagnosed with acute cholecystitis. The patient is extremely nauseous. A nasogastric tube is inserted with GI decompression. The patient reports a pain rating of 9 on 1-10 scale and states the pain radiates to the shoulder blade. Select all the appropriate nursing interventions for the patient: […] The treatment for cholecystitis includes managing pain, managing nausea/vomiting (a NG tube with GI decompression (removal of stomach contents) to low intermittent suction may be ordered to help severe cases), keep patient NPO until signs and symptoms subside, mouth care from vomiting and nasogastric tube, and administer IV fluids to keep the patient hydrated.

• #25 Cholelithiasis and Cholecystitis Nursing Care Plan & Management

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/cholelithiasis-and-cholecystitis-nursing-management/

  Assess incision sites for infection after laparoscopic cholecystectomy. […] Advise the client that he will need assistance at home for 2 to 3 days after surgery. […] Monitor for signs and symptoms of increased or continued nausea or vomiting, abdominal cramps, weakness, twitching, seizures, irregular heart rate, paresthesia, hypoactive or absent bowel sounds, and depressed respirations. […] Administer antibiotics if prescribed to treat the infectious process, reducing inflammation. […] Discuss avoidance of food/fluids high in fats, gas producers, or gastric irritants to limit or prevent recurrence of gallbladder attacks.

• #26

  https://www.nursingcenter.com/journalarticle?Article_ID=481822&Journal_ID=54030&Issue_ID=54558

  Recognizing the signs and symptoms and preventing complications. […] You suspect that Ms. Lawson has acute cholecystitis. Patients with this condition complain of sudden-onset, severe, and ongoing pain in the RUQ or epigastric region of the abdomen. […] You initiate an IV running normal saline at 125 cc/hour. […] Antibiotics are generally withheld in straightforward, uncomplicated cases of acute cholecystitis, but they are ordered in cases of acute peritonitis or sepsis. […] Acute cholecystitis is managed either medically or surgically, but surgical intervention is the treatment of choice. […] Surgical cholecystectomy is performed by either laparoscopy or laparotomy. […] Laparoscopic cholecystectomy has become more common in cases of uncomplicated acute cholecystitis. […] Immediate cholecystectomy is performed if peritonitis is suspected. […] Critically ill patients who can’t tolerate a full surgical procedure are managed more conservatively through placement of a drainage tube in the gallbladder. […] Following an uneventful postoperative recovery, she is discharged after three days.

• #27 Evidence-based Guidelines for the Management of Acute Cholecystitis

  https://www.pajtcces.com/abstractArticleContentBrowse/PAJT/31337/JPJ/fullText

  The management of acute cholecystitis should never be viewed as routine, particularly regarding the heterogeneity of the patients clinical status and severity of the disease process. […] Adherence to up-to-date, evidence-based, and expert consensus practice is critical to optimal outcomes for these patients. […] Laparoscopic cholecystectomy is the procedure of choice for acute cholecystitis. […] Many preoperative considerations exist, including patient health status/risk stratification, the severity of cholecystitis, choice of antibiotics, etiology of cholecystitis, considerations for gravid mothers, and utilization of cholecystostomy tubes. […] Intraoperative considerations are similarly paramount, including the surgical approach, adjuncts, and grading of the severity of cholecystitis once in the operating room.

• #28 Acute Cholecystitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/19448

  Educating the patient and family is vital since the condition does carry a high mortality. […] The preoperative nurse should ensure that the patient has the requisite clearance, ECG, chest x-ray, and blood work before the surgery. If there are any deficiencies or concerns, the surgeon should be contacted prior to the procedure. […] After the procedure, the nurse will monitor vital signs and assist in managing the patient’s pain. If there is any significant change in vital signs or the pain cannot be controlled with the medications provided, the surgeon should be consulted.

• #29 Pulsenotes | Acute cholecystitis notes

  https://app.pulsenotes.com/surgery/general-surgery/notes/acute-cholecystitis

  MRCP +/- ERCP: MRCP allows for confirmation of stones in the biliary tree (if confirmed on other imaging you may proceed straight to ERCP). When present, ERCP allows for therapeutic intervention with stone retrieval +/- sphincterotomy +/- stent placement prior to cholecystectomy. […] On-table cholangiogram: less commonly available and technically challenging. During the laparoscopic cholecystectomy, the bile duct is intubated to allow the injection of dye with fluoroscopy in theatre to diagnose stones in the biliary tree. Various techniques may then be used to retrieve/expel stones. […] In patients with significant co-morbidities, a cholecystectomy may represent unacceptable risk and as such more conservative measures trialed.

• #30 Acute Cholecystitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/19448

  Prior to discharge, the patient should be advised on possible intolerance to greasy food, which may cause bloating or diarrhea. This can be temporary or, at some degree permanent, due to the decreased speed of fat emulsification by the loss of stored bile in the gallbladder. Most patients will have an up-regulation in bile production by the liver and will see improvement in symptoms with time. […] Follow-up time is between 3-4 weeks from operation. […] Managing acute cholecystitis is now routine, and most patients have an excellent prognosis. However, problems arise in patients with acalculous cholecystitis and when there are bile duct stones. Patients with acalculous cholecystitis are often managed in the intensive care unit and may undergo an initial aspiration procedure until they are fit to undergo formal surgery.

• #31 Cholecystitis ppt | PPT

  https://www.slideshare.net/slideshow/cholecystitis-ppt/225575178

  3 Maintain nutritional balance. Calculate calorie intake. Keep comments about appetite to its minimum. Weigh as indicated. Consult with patient about likes and dislikes, foods that causes distress, and preferred meal schedule. […] Discharge and Home Care Guidelines The focus of discharge instructions for patients with cholecystitis is education. Education. Patients with cholecystitis must be educated regarding causes of their disease, complications if left untreated, and medical and surgical options.

• #32 Cholecystitis Nursing Care Management and Study Guide

  https://nurseslabs.com/cholecystitis/

  Cholecystitis is the acute or chronic inflammation of the gallbladder. […] Management of cholecystitis include the following: […] The major goals for the patient include: relieve pain and promote rest, maintain fluid and electrolyte balance, prevent complications, provide information about disease process, prognosis, and treatment needs. […] Treatment of cholecystitis depends on the severity of the condition and the presence or absence of complications. […] Expected patient outcomes are: pain relieved, homeostasis achieved, complications prevented/minimized, disease process, prognosis, and therapeutic regimen understood. […] The focus of discharge instructions for patients with cholecystitis is education. […] Patients with cholecystitis must be educated regarding causes of their disease, complications if left untreated, and medical and surgical options.

• #33 Cholecystitis (gallbladder inflammation) | healthdirect

  https://www.healthdirect.gov.au/cholecystitis-gallbladder-inflammation

  Cholecystitis needs to be treated in hospital. […] Treatment usually involves: fasting (not eating and drinking), intravenous (IV) fluids fluids given through a drip, antibiotics, pain-relief medicines, surgery to remove your gallbladder. […] Surgery to remove your gallbladder is called a cholecystectomy. This is standard treatment if your cholecystitis is caused by gallstones. […] After the operation, bile will flow straight from your liver to your small intestine. You can live a normal life without your gallbladder.

• #34 Cholecystitis NCLEX Nursing Review

  https://www.registerednursern.com/cholecystitis-nursing-nclex-review/

  Antibiotics for infection (IV) […] Drain care […] C-tubes are place through the abdominal wall and into the gallbladder. They are for patients who cant have surgery immediately to remove the gallbladder but the infected bile needs to be removed. […] Things to remember: […] Monitor insertion site for infection […] Flush per MD order so it wont get blocked and teach patient how to care for drain. […] Deterioration signs and symptoms? How to tell if treatment is not helping and the patient is getting worst? […] Mental status changes, increased heart rate, decreased blood pressure, high temperature, high WBC, change in stool consistency and color (steatorrhea, light colored, jaundice, dark urineno bilirubin), increasing or worsening abdominal pain (RUQ) […] Make sure the patient is ambulating soon after the procedure to prevent post-opt complications and coughing and deep breathing (splinting incision)remind the patient how to use the incentive spirometer. […] Monitor drainage and that is it actually draining because it can become blocked.

• #35 Acute cholecystitis – Management recommendations | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000084/management-recommendations

  The procedure involves inserting a drainage catheter in the gallbladder through a small entry hole made in the abdominal wall. […] This procedure could relieve the symptoms completely, or at least allow the patients condition to improve sufficiently for a definitive elective procedure (laparoscopic cholecystectomy) to be undertaken later, rather than in an emergency situation. […] An incomplete or poor response to cholecystostomy within the first 48 hours may indicate causes of sepsis other than cholecystitis, inadequate antibiotic coverage, possible complications (such as dislodgement of the drainage tube), or necrosis of the wall of the gallbladder. […] Gallbladder empyema can result when cholecystitis is left to progress with concurrent bile stasis and cystic duct obstruction. […] It is a surgical emergency.

• #36 Acute Cholecystitis – Core EM

  https://coreem.net/core/acute-cholecystitis/

• #37 Acute cholecystitis – Management recommendations | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000084/management-recommendations

  In patients with severe acute cholecystitis (grade III according to the Tokyo guideline), transfer the patient to the intensive care unit to monitor and treat the organ dysfunction. […] Ensure pain is treated promptly and effectively. […] Use a pain score to monitor the response to analgesia and adjust the dose and/or type of analgesic medication in line with local pain management protocols. […] Assess fluid status and resuscitate with intravenous fluids as appropriate. […] Administer intravenous fluids, if needed, to all patients who cannot tolerate oral intake. […] Regularly monitor patients receiving intravenous fluids. […] Treat the underlying cause as early as possible. […] Follow your local protocol for investigation and treatment of all patients with suspected sepsis, or those at risk.

• #38 4 Cholecystitis and Cholelithiasis Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cholecystitis-cholelithiasis-nursing-care-plans/

  The client will demonstrate adequate fluid balance evidenced by stable vital signs, moist mucous membranes, good skin turgor, capillary refill, individually appropriate urinary output, and absence of vomiting. […] The client will report relief or control of pain. […] The client will report relief from nausea/vomiting. […] The client will verbalize understanding of the disease process, prognosis, and potential complications. […] The client will initiate necessary lifestyle changes and participate in the treatment regimen.

• #39 Acute Cholecystitis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568804/

  Monitor laboratory data and report if there is any abnormality. […] Ensure a pregnancy test done if the patient is female. […] Teach the patient that they will probably experience pain to their right shoulder due to insufflation of air during a lap-chole procedure and should increase activity (such as walking as tolerated) to assist with reducing this pain. […] Free of pain and nausea. […] Able to tolerate a diet. […] able to do daily activities as before. […] Vital signs […] Abdominal exam […] Urine output […] Skin and eye color […] Managing acute cholecystitis is now routine, and most patients have an excellent prognosis. […] Educating the patient and family is vital since the condition does carry a high mortality. […] Patients with numerous comorbid factors need to be evaluated by the cardiologist prior to general anesthesia.

• #40 Nursing care plan for acute cholecystitis

  https://nursipedia.com/nursing-care-plan-acute-cholecystitis/

  Acute Cholecystitis is an inflammation of the gallbladder, usually caused by a blockage of the gallbladder or bile ducts by gallstones. Nursing care plan for Acute Cholecystitis is focused on providing relief to the patient from the associated pain and preventing future complications. […] The patient will demonstrate reduced pain with decreased need for analgesic medications; improved fluid and electrolyte balance; will present with no signs of infection; and have improved nutrition through oral intake. […] Pain management is important to reduce the pain experienced by the patient and to improve comfort. Implementing strategies to balance fluids and electrolytes is important to ensure normal functioning of the body organs. Preventing infection is important to reduce the risk of complications. Enhancing nutrition can accelerate the wound healing process and promote overall health of the patient.

• #41

  https://ecohumanism.co.uk/joe/ecohumanism/article/view/6189

  Background: Acute cholecystitis, an inflammation of the gallbladder, often presents with right upper quadrant pain, fever, and nausea. […] Nurses play a significant role in addressing both the physical and emotional aspects of care. Aim: This review aims to provide an updated understanding of acute cholecystitis, focusing on nursing intervention protocols for effective patient care. […] Key nursing diagnoses, including anxiety, pain, and nutritional deficits, were explored. […] The review highlights several critical nursing interventions for acute cholecystitis management. These include pain management strategies, patient education to alleviate anxiety, monitoring nutritional status, and ensuring fluid balance. […] Additionally, nursing roles in preoperative care, such as educating patients about the procedure and postoperative care expectations, are essential to reducing anxiety and promoting cooperation.

• #42

  https://ecohumanism.co.uk/joe/ecohumanism/article/view/6189

  Acute cholecystitis demands comprehensive nursing care, including pain relief, emotional support, and nutritional management. […] Nurses must be skilled in recognizing the symptoms, facilitating timely interventions, and preparing patients for surgery. […] Effective nursing management leads to improved patient comfort, reduced anxiety, and enhanced postoperative outcomes.

• #43 Acute Cholecystitis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568804/

  The preoperative nurse should ensure that the patient has the requisite clearance, ECG, Chest x-ray, and blood work prior to the surgery. […] For patients with uncomplicated acute cholecystitis, the prognosis is excellent. […] The pain is minimal and can be managed by over the counter analgesics. […] Follow up time is between 3-4 weeks from operation. […] Avoid foods high in fat and maintain healthy diet. […] Avoid foods that cause gas like carbonated beverages, coffee.

• #44 Cholecystitis Nursing Care Plan & Example | Free PDF Download

  https://www.carepatron.com/templates/cholecystitis-nursing-care-plan

  Nurses can educate the patient on their condition, including risk factors, management strategies, and when to seek further medical attention if symptoms worsen. Education should also include post-operative instructions if surgery is required. […] A nursing care plan offers several advantages for managing cholecystitis, enhancing patient care, and promoting recovery. The plan is tailored to each patients unique needs, considering their medical history, including any history of gallbladder disease, signs and symptoms, pain levels, and overall health. […] A well-structured care plan provides a clear roadmap for recovery, outlining both short-term and long-term goals, such as managing pain and preventing recurrence. […] The care plan is a communication tool among healthcare providers, including nurses, doctors, and specialists, ensuring everyone is aligned to support the patient’s recovery. […] Monitoring the patient’s condition regularly and implementing preventive measures are integral to the care plan. […] The plan provides patients with crucial information about their condition, treatment options, and self-care strategies, empowering them to participate actively in their recovery.

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