(^290) Medical-Surgical Nursing Demystified
- avoid morphine (may cause spasm of sphincter of Oddi, increasing pain).
- Administer antibiotics for acute symptoms.
- Placement of stent into gallbladder if the patient is not a candidate for surgery.
- Ultrasound-guided aspiration of gallbladder.
- Surgical removal of gallbladder:
- Laparoscopic cholecystectomy
- Open cholecystectomy
NURSING DIAGNOSES
- Acute pain
- Chronic pain
- Risk for imbalanced nutrition: less than what body requires
- Nausea
NURSING INTERVENTION
- Monitor vital signs for changes in temperature, pulse rate, respiratory rate,
and blood pressure. - Assess abdomen for bowel sounds, distention, and tenderness.
- Assess pain level for adequate pain control.
- Assess postoperative wound for drainage, signs of infection.
- Monitor T-tube drainage in postoperative open cholecystectomy patients;
empty and record at least every 8 hours. - Advance diet to low-fat diet postoperatively as tolerated.
Cirrhosis
WHAT WENT WRONG?
Injury to the cellular structure of the liver causes fibrosis due to chronic inflamma-
tion and necrotic changes, resulting in cirrhosis. There are nodular changes to the
liver. The bile ducts and blood vessels through the liver may become blocked due
to both the nodular changes and fibrosis. These changes to the liver cause enlarge-
ment of the organ and change in texture. There is increased pressure within the3