Patient Description: The patient is a 65 year-old female diagnosed with cholecystitis, an acute or chronic inflammation of the gallbladder generally associated with gallstones impacted in the cystic duct, thereby causing distension of the gallbladder (Nursing Care Plan, 2009a). Crystals can also form in the submucosa of the gallbladder causing inflammation and necessitating surgery in extreme cases. According to Coleman (1989), patients suffering from acute cholecystitis accompanied by cholelithiasis are usually treated by surgery although several other treatment methods involving fragmentation and dissolution of stones are now being used.
Care Setting: The care setting for this patient is hospitalization in a medical unit and the plan of care addresses the acutely ill, hospitalized patient.
Related Concerns: Cholecystectomy fluid and electrolyte imbalances, psychosocial aspects of care, total nutritional support, parenteral/enteral feeding, and patient assessment database.
Activity/Rest: Patient exhibits fatigue combined with periodic restlessness (Nursing care plan, 2009a).
Circulation: Patient exhibits slight tachycardia coupled with diaphoresis and periodic lightheadedness.
Elimination: Changes in color of urine and stools, abdominal distension characterized by palpable mass in right upper quadrant.
Food/Fluid: Patient reports intolerance of fatty/gas forming foods, heartburn, indigestion, flatulence, and bloating.
Pain/Discomfort: Patient reports moderate to severe epigastric and right upper abdominal pain and midepigastric colicky pain associated with eating. Positive Murphy's sign.
Respiration/Safety: Patient exhibits increased respiratory rate marked by shallow breathing. Exhibits low grade fever with periodic itching skin and jaundice.
Planning: Conduct bilary ultrasound and oral cholecystography. Use fluoroscope imaging to distinguish between gall
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