I.

INTRODUCTION

Cholecystitis is an inflammation of the gallbladder wall and nearby abdominal lining.

Cholecystitis is usually caused by a gallstone in the cystic duct, the duct that connects the
gallbladder to the hepatic duct. The presence of gallstones in the gallbladder is called
cholelithiasis. Cholelithiasis is the pathologic state of stones or calculi within the
gallbladder lumen. A common digestive disorder worldwide, the annual overall cost of
cholelithiasis is approximately $5 billion in the United States, where 75-80% of
gallstones are of the cholesterol type, and approximately 10-25% of gallstones are
bilirubinate of either black or brown pigment. In Asia, pigmented stones predominate,
although recent studies have shown an increase in cholesterol stones in the Far East.

Gallstones are crystalline structures formed by concretion (hardening) or accretion

(adherence of particles, accumulation) of normal or abnormal bile constituents.
According to various theories, there are four possible explanations for stone formation.
First, bile may undergo a change in composition. Second, gallbladder stasis may lead to
bile stasis. Third, infection may predispose a person to stone formation. Fourth, genetics
and demography can affect stone formation.

Risk factors associated with development of gallstones include heredity, Obesity,

rapid weight loss, through diet or surgery, age over 60, Native American or Mexican
American racial makeup, female gender-gallbladder disease is more common in women
than in men. Women with high estrogen levels, as a result of pregnancy, hormone
replacement therapy, or the use of birth control pills, are at particularly high risk for
gallstone formation, Diet-Very low calorie diets, prolonged fasting, and low-fiber/high-
cholesterol/high-starch diets all may contribute to gallstone formation.

Sometimes, persons with gallbladder disease have few or no symptoms. Others,

however, will eventually develop one or more of the following symptoms; (1) Frequent
bouts of indigestion, especially after eating fatty or greasy foods, or certain vegetables
such as cabbage, radishes, or pickles, (2) Nausea and bloating (3) Attacks of sharp pains
in the upper right part of the abdomen. This pain occurs when a gallstone causes a
blockage that prevents the gallbladder from emptying (usually by obstructing the cystic
duct). (4) Jaundice (yellowing of the skin) may occur if a gallstone becomes stuck in the
common bile duct, which leads into the intestine blocking the flow of bile from both the
gallbladder and the liver. This is a serious complication and usually requires immediate
treatment.
The only treatment that cures gallbladder disease is surgical removal of the
gallbladder, called cholecystectomy. Generally, when stones are present and causing
symptoms, or when the gallbladder is infected and inflamed, removal of the organ is
usually necessary. When the gallbladder is removed, the surgeon may examine the bile
ducts, sometimes with X rays, and remove any stones that may be lodged there. The ducts
are not removed so that the liver can continue to secrete bile into the intestine. Most
patients experience no further symptoms after cholecystectomy. However, mild residual
symptoms can occur, which can usually be controlled with a special diet and medication.
 II. NURSING ASSESSMENT
A. Personal History

Mr. Aproniano Castro is a 56 year old male, a Filipino citizen who resides at Pulong
Santol, Porac Pampanga. He was born on January 22, 1950 at Pulong Santol, his
religious affiliation is Roman Catholic and he is married to Mrs. Brigida M. Castro. He is
a jeepney driver bound in Porac-Angeles route. He is also the president of their jeepney’s
association. Mr. Castro usually works for 10 to 12 hours a day usually around 7am to 7
pm. He always sleeps around 9 in the evening and wakes up at 6 in the morning. His
wife was the one who prepares him the breakfast and the snack. He has day-offs but uses
this day in working as the president of the jeepney association. He usually eats instant
food and love eating foods which has condiment like “patis”, vinegar and soy sauce. He
also love eating vegetable salads and fatty salty food. He is not also choosy on the food
he eats because he really eat a lots. He seldom drinks alcohol and smoke. Regarding the
finances about health he is using his wife’s PHILHEALTH card to compensate the
finances needed. Family Health and Illness History

B. Family Health and Illness History

According to Mr. Castro that the familial disease he knows that they have in their
family was the hypertension that is on his father’s side. His father died because of heart
attack and her mother died of natural cause. He also added that cholecystitis is prone to
their family, because of one of his siblings also had acquired this disease.

C. History of Past and Present Illness

This is the second time Mr. Castro been admitted into this hospital (Porac District
Hospital). On his first admission into this hospital he had undergone throidectomy
operation, which is almost 3 years ago. He had not experience any accident and injuries,
even though his job is prone to accident particularly vehicular accident. He also added
that he had an ashtma when he was 7 years old that lasts when he is 21 years old, his
ashtma just stopped when he start drinking alcohol beverages as he said.
 As for his present illness, he was admitted into this hospital because of cholecystitis,
he was admitted last February 13, 2006. He was been diagnosed with cholecystitis with
multiple cholelithiasis a month prior to admission due to severe epigastric pain and
weight loss and was advised to remove his gallbladder. He just did not have his
cholecystectomy done immediately due to financial problem. When the money needed
for his operation was enough he then goes to Porac District Hospital last February 13,
2005 for his operation. He was diagnosed and surgically operated by Dr.
Serrano.According to Mr. Castro. Upon admission he had undergone some laboratory
examination such as UTZ, Chest X-ray, U/A, CBC, FBS, BUN,Creatinine and ECG. His
initial medication were H2bloc and Cefuroxime.

D. Physical Examination

Physical Assessment done by the attending physician reveals that patient is;
 afebrile
 with pink palpebral conjunctiva
 (-) cyanosis
 (+) NABS
 non tender abdomen

Vital Signs upon admission (February 13, 2006)

BP- 130/90
RR-19
PR-84
Temp-36.5 oC

Physical Assessment done by the student reveals that patient is;

 afebrile
 with pink palpebral conjunctiva
 (+) dry lips
 (+) paleness
 (+) dryskin
 decreased skin turgor
 (-) bowel movement
 (-) weakness
Vital Signs taken and recorded as of February 15, 2006 are as follows;
BP- 140/90
PR- 85
RR- 21
Temp- 36.4 oC
 III. ANATOMY AND PHYSIOLOGY

Gallbladder, muscular organ that serves as a reservoir for bile, present in most

vertebrates. In humans, it is a pear-shaped membranous sac on the undersurface of the

right lobe of the liver just below the lower ribs. It is generally about 7.5 cm (about 3 in)
long and 2.5 cm (1 in) in diameter at its thickest part; it has a capacity varying from 1 to
1.5 fluid ounces. The body (corpus) and neck (collum) of the gallbladder extend
backward, upward, and to the left. The wide end (fundus) points downward and forward,
sometimes extending slightly beyond the edge of the liver. Structurally, the gallbladder
consists of an outer peritoneal coat (tunica serosa); a middle coat of fibrous tissue and
unstriped muscle (tunica muscularis); and an inner mucous membrane coat (tunica
mucosa).
The function of the gallbladder is to store bile, secreted by the liver and transmitted
from that organ via the cystic and hepatic ducts, until it is needed in the digestive process.
The gallbladder, when functioning normally, empties through the biliary ducts into the
duodenum to aid digestion by promoting peristalsis and absorption, preventing
putrefaction, and emulsifying fat. Digestion of fat occurs mainly in the small intestine, by
pancreatic enzymes called lipases. The purpose of bile is to; help the Lipases to Work, by
emulsifying fat into smaller droplets to increase access for the enzymes, Enable intake of
fat, including fat-soluble vitamins: Vitamin A, D, E, and K, rid the body of surpluses and
metabolic wastes Cholesterol and Bilirubin.
 IV. PATHOPHYSIOLOGY

Risk factor

Heredity

Obesity

Rapid Weight Loss, through diet or surgery

Age Over 60

Female Gender

Diet-Very low calorie diets, prolonged fasting, and low-fiber/high-

Bilecholesterol/high-starch
must become diets. The solute precipitate Crystals must come
supersaturated with from solution as solid together and fuse to form
cholesterol and calcium crystals stones

Gallstones

Obstruction of the cystic duct and common bile duct

Sharp pain in the right Jaundice

part of abdomen

Distention of the gall bladder

Venous and Proliferation of Localized cellular Areas of

lymphatic drainage bacteria irritation or ischemia may
is impaired infiltration or both occur
take place

Inflammation of gall bladder

CHOLECYSTITIS
 V. DIAGNOSTIC AND LABORATORY PROCEDURE

1. Complete Blood Count (CBC)

This is to determine blood components and the response to

inflammatory process and streptococcal infection.
Date Ordered: February 13, 2006
Date Result In: February 13, 2006

Results:
WBC - 10.9 g/l
RBC - 5.5 g/l
Lymphocyte - 27
Conclusion:
WBC is slightly elevated based on the normal value of 4.3-10 g/l which
confirms the presence of infection.

2. Fasting Blood Sugar

This is to measure the blood glucose levels.

Date Ordered: February 13, 2006
Date Result In: February 13, 2006

Results:
94.8 mg/dl
Conclusion:
The result is within normal range based on the normal value of < 126
mg/dl.
 3. Creatinine

This is the indicator of the renal function

Date Ordered: February 13, 2006

Date Result In: February 13, 2006

Results:
1.0 mg/dl
Conclusions:
The result is within normal range based on the normal value of 0.60-1.7
mg/dl.
4. BUN

This is an indicator of renal function and perfusion, dietary intake of

CHON and the level of protein metabolism

Date Ordered: February 13, 2006

Date Result In: February 13, 2006
Results:
10.7 Mg/dl
Conclusions:
The result is within normal range based on the normal value of mg/dl.

5. Urinalysis

Urinalysis yields a large amount of information about possible disorders of

the kidney and lower urinary tract, and systematic disorders that alter urine composition.
Urinalysis data include color, specific gravity, pH, and the presence of protein, RBC’s,
WBC’s, bacteria, Leukocyte, esterase, bilirubin,glucose, ketones, casts and crystals.
 Date Ordered: February 10, 2006
Date Result In: February 10, 2006
Results:
Color- yellow
Specific Gravity- 0.010
Sugar/ Albumin- negative
Pus cells- 0.1 hpf
Conclusions:
The results are normal but there is a presence of pus cells in the urine
which means that there is also the presence of infection.
 VI. Patients Care

a. Nursing Care Plan

Preoperative NCP

1. Acute Pain

Cues Nursing Scientific Objectives Nursing Rationale Evaluation

Diagnosis Explanations Interventions
S Acute pain Due to the After 4 hours 1. Observe and - Assists in Is there a change
 related to presence of of nursing document differentiating cause on the patients;
inflammation stones in the intervention location, of pain, and provides a. Pain scale
and distortion gallbladder it the patient will severity (0–10 information about b. RR
O of the causes some report relieve scale), disease c. BP
- pain scale gallbladder as obstruction in of pain. and character of progression/resolution, d. Reports of
of 7/10 evidenced by the cystic duct pain (e.g., development of pain
- difficulty in verbal reports which in turn steady, complications, and e. Facial
moving as of pain. causes a sharp intermittent, effectiveness of expression
manifested acute pain on colicky). interventions. s.
by facial the right part of
grimaces the abdomen. 2. Promote - Bedrest in low-
- (+) pallor bedrest, Fowler’s position
- (+) muscle allowing patient reduces intra-
guarding to assume abdominal
- RR- 30 position of pressure; however,
- BP- 140/90 comfort. patient will naturally
assume least
painful position.

3. Control - Cool surroundings

environmental aid in minimizing
temperature. dermal discomfort.

4. Encourage - Promotes rest,

use of redirects attention,
relaxation may enhance coping.
techniques, e.g.,
guided
imagery,
visualization,
deep-breathing
exercises.
Provide
diversional
activities.

5. Make time - Helpful in alleviating

to listen to and anxiety and refocusing
maintain attention,
frequent contact which can relieve
with pain.
patient.

6. Administer - Relief of pain

analgesics as facilitates cooperation
indicated with other
therapeutic
interventions,
 2. Fluid Volume deficient

Cues Nursing Scientific Objectives Nursing Rationale Evaluation

Diagnosis Explanations Interventions
S Fluid Volume Because of After series of 1. Maintain - Provides Is there still the
 Deficient vomiting NI the pt. will accurate record information presence of;
related to excessive losses maintain of I&O, noting about fluid a. vomiting
vomiting through normal adequate fluid output less than status/circulating b. dry skin
O routes occur volume as Intake, increased volume and c. dry mouth
- (+) pallor thus causes evidenced by urine specific replacement d. poor skin
- (+) body Fluid Volume moist mucous gravity. Assess needs. turgor
weakness Deficient membranes and skin/mucous e. body
- (+) good skin membranes, weakness
vomiting turgor, peripheral
- with pulses, and
poor skin capillary
turgor refill.
- (+) dry
skin 2. Perform - Decreases
- (+) dry frequent oral dryness of oral
mouth hygiene mucous
membranes;
reduces
risk of oral
bleeding.

3. Provide skin - Skin and

and mouth care mucous
membranes are
dry, with
decreased
 elasticity,
because of
vasoconstriction
and reduced
intracellular
water.
4. Increase fluid - promotes
intake hydration.

5. Ascertain - Relieves thirst

patient’s and discomfort
beverage of dry mucous
preferences, and membranes
set up a 24- and augments
hr schedule for parenteral
fluid intake. replacement.
Encourage foods
with high
fluid content.

6. Administer - Reduces
antiemetics, e.g., nausea and
prochlorperazine prevents
(Compazine) as vomiting.
ordered by the
physician.
Post-operative NCP
3. Knowledge Deficit

Cues Nursing Scientific Objectives Nursing Rationale Evaluation

Diagnosis Explanations Interventions
S Deficient There is this After an hour 1. Provide - Information can - Does
“pwede bang knowledge presence of of nurse- explanations decrease anxiety, the patient
maulit ang sakit related to knowledge patient of/reasons for test thereby reducing understands
ko” as verbalized condition, deficit due to interaction the procedures and sympathetic and could
by the patient prognosis, some patient will preparation stimulation. recall all
treatment, unfamiliar Verbalize needed. the
self-care, information understanding teachings
O and that causes of disease 2. Review - Provides knowledge given?
- Frequently discharge some process, disease base from which - Is there
asking needs confusion to prognosis, and process/prognosis. patient can make a
question the client that potential Discuss informed choices. significant
about his needs to be complications. hospitalization Effective changes
condition, discussed. and prospective communication and that occur
treatment and treatment as support on the
diet indicated. at this time can patients
- With worried Encourage diminish anxiety and knowledge
gaze questions, promote healing. regarding;
expression of a. disease
concern. condition
b. diet
- Gallstones often c. treatment
3. Review drug recur, necessitating d. medication
regimen, possible long-term therapy. e. self-care
side effects. needs

- Prevents/limits
4. Instruct patient recurrence of
to avoid gallbladder attacks.
food/fluids high
in fats (e.g.,
whole milk, ice
cream, butter,
fried foods, nuts,
gravies,
pork), gas
producers (e.g.,
cabbage, beans,
onions,
carbonated
beverages), or
gastric irritants
(e.g., spicy
foods, caffeine,
citrus).
- Promotes gas
5. Suggest patient formation, which can
limit gum increase gastric
chewing, sucking distension/discomfort.
on straw/hard
candy, or
smoking.
 b. Drug Study

Name of Drug Date Route/ Action Indication Adverse Nursing Consideration

Ordered Dosage and Reaction
Frequency
GN: H2Bloc 02-13-06 PO - Anti-ulcer -for short term - headache, 1. Check for doctor’s order
(Pepcidine) 20 mg tab at - competitively treatment of dizziness, 2. not to be given in patients
BN: bedtime inhibits action duodenal ulcer malaise, dry hypersensitive to drugs
Famotidine of histamine on mouth 3. Inform the patient about the
the H2 at possible side effect of the drug
receptor sites of 4. Instruct patient to take drug
parietal cells, with food
decreasing 5. Advised patient to take drug
gastric acid once daily usually at bed time
secretion 6. Advise patient to report
abdominal pain or blood in
stools or is vomiting.

GN: 02-13-06 IV - anti-infective - perioperative - Nausea and 1. Check for doctor’s order
Cefuroxime 750 mg - a 2nd prophylaxis Vomiting 2. Perform ANST prior to
BN: Zinacef every 8o generation admission
prior to OR cephalosporin 3. Should not be given if
(30 to 60 that inhibits positive skin test
minutes cell-wall 4. Slow IV push
before) synthesis, 5. Inform the patient about the
promoting possible side effect of the drug
osmotic 6. Advise patient to report any
instability discomfort on the IV insertion
site
Name of Drug Date Route/ Action Indication Adverse Nursing Consideration
Ordered Dosage and Reaction
Frequency
GN: 02-13-06 PO - Anti- - for depression - headache, 1. Check for doctor’s order
Clomipramine 10 mg tab, depressants and chronic pain dizziness, 2. not to be given in patients
HCl at 6 am malaise, dry hypersensitive to drugs
BN: Placil mouth 3. Inform the patient about the
possible side effect of the drug

GN: 02-14-06 IV - Anti-infective - endocarditis - Nausea and 1. Check for doctor’s order
Gentamicin 80 mg amp, - inhibits prophylaxis for Vomiting, 2. Perform ANST prior to
Dulfate every 80 protein GI or GU headache, admission
BN: Genticin synthesis procedure or dizziness 3. Should not be given if
surgery positive skin test
4. Slow IV push
5. Inform the patient about the
possible side effect of the drug
6. Advise patient to report any
discomfort on the IV insertion
site
7. Monitor urine output, specific
gravity, U/A, BUN and
creatinine levels
Name of Drug Date Route/ Action Indication Adverse Nursing Consideration
Ordered Dosage and Reaction
Frequency
GN: Ampicillin 02-14-06 IV - Anti-infective - endocarditis - Nausea and 1. Check for doctor’s order
BN: Omnipen 1 g amp, - inhibits prophylaxis for Vomiting, 2. Perform ANST prior to
every 80 protein GI or GU headache, admission
synthesis procedure or dizziness 3. Should not be given if
surgery positive skin test
4. Slow IV push
5. Inform the patient about the
possible side effect of the drug
6. Advise patient to report any
discomfort on the IV insertion
site

GN: MgSO4 02-14-06 IV -anti-convulsant - magnesium - drowsiness, 1. Use parenteral magnesium

0.03% 7ml -replaces supplementation hypotension with extreme caution in patients
every 120 magnesium and with impaired renal function
maintains 2. Test knee jerk and patellar
magnesium reflexes before each additional
level dose
3. check magnesium level after
repeated doses
4. Monitor fluid intake and
output
5. Monitor renal function
Name of Drug Date Route/ Action Indication Adverse Nursing Consideration
Ordered Dosage and Reaction
Frequency
GN: Ketorolac 02-14-06 IV - Anti- - short term - dizziness, 1. Check for doctor’s order
Tromethamine 30 mg amp, inflammatory management of sedation, 2. Perform ANST prior to
BN: Toradol every 60 - inhibits moderately headache, admission
prostaglandin severe, acute pain flatulence, 3. Should not be given if
synthesis nausea and positive skin test
vomiting 4. Slow IV push
5. Inform the patient about the
possible side effect of the drug
6. Advise patient to report any
discomfort on the IV insertion
site

Name of Drug Date Route Action Adverse Reaction Nursing Consideration

Ordered
GN: Lidocaine HCl 02-14-06 IV Anesthetic -lethargy, 1. Monitor BP, PR, and RR before and
drugs hypotension after giving the medication

2. Monitor patient for toxicity

Anesthetic drug
c. Medical/ Surgical Management

1. Chest X-ray- this is used to rule out respiratory causes of referred pain.
2. Intake and Output- I&O measurement provide an other means of
assessing fluid balance. This data provide insight into the cause of
imbalance such as decrease fluid intake or increase fluid loss. These
measurement are not that accurate as body weight, however, because of
relative risk of errors in recording.
3. Electrocardiogram- The ECG is an essential tool in evaluating cardiac
rhythm. Electrocardiography detects and amplifies the very small
electrical potential changes between different points on the surface of the
body as a myocardial cell depolarize and repolarize, causing the heart to
contract.
4. O2 Inhalation- Oxygen therapies are used to provide more oxygen to the
body into order to promote healing and health.
5. Intravenous Rehydration- when the fluid loss is severe or life
threatening, intravenous (IV) fluids are used for replacement.
6. ultrasound (Also called sonography.) - a diagnostic imaging technique
which uses high-frequency sound waves to create an image of the
internal organs. Ultrasounds are used to view internal organs of the
abdomen such as the liver spleen, and kidneys and to assess blood flow
through various vessels.
7. hepatobiliary scintigraphy - an imaging technique of the liver, bile ducts,
gallbladder, and upper part of the small intestine.
8. cholangiography - x-ray examination of the bile ducts using an
intravenous (IV) dye (contrast).
9. percutaneous transhepatic cholangiography (PTC) - a needle is
introduced through the skin and into the liver where the dye (contrast) is
deposited and the bile duct structures can be viewed by x-ray.
10. endoscopic retrograde cholangiopancreatography (ERCP) - a procedure
that allows the physician to diagnose and treat problems in the liver,
 gallbladder, bile ducts, and pancreas. The procedure combines x-ray and
the use of an endoscope. A long, flexible, lighted tube. The scope is
guided through the patient's mouth and throat, then through the
esophagus, stomach, and duodenum. The physician can examine the
inside of these organs and detect any abnormalities. A tube is then
passed through the scope, and a dye is injected which will allow the
internal organs to appear on an x-ray.
11. computed tomography scan (CT or CAT scan) - a diagnostic imaging
procedure using a combination of x-rays and computer technology to
produce cross-sectional images (often called slices), both horizontally
and vertically, of the body. A CT scan shows detailed images of any part
of the body, including the bones, muscles, fat, and organs. CT scans are
more detailed than general x-rays.
12. Cholecystectomy- removal of the gallbladder. This procedure may be
performed to treat chronic or acute cholecystitis, with or without
cholelithiasis, to remove a malignancy or to remove polyps.
13. Cholecystotomy- the establishment of an opening into the gallbladder to
allow drainage of the organ and removal of stones. A tube is then placed
in the gallbladder to established external drainage. This is performed
when the patient cannot tolerate cholecystectomy.
14. Choledochoscopy- the insertion of a choledoscope into the common bile
duct in order to directly visualize stones and facilitate their extraction.
 VII. Clients Daily Progress

DAYS ADMISSION DAY 2 DAY 3 DISCHARGE

2/13/06 2/14/16 2/15/16 2/16/06
Nursing Problem
Acute pain * *
Fluid Volume Deficient * *
Knowledge Deficit * *
Vital Signs BP- 130/90 BP- 140/90 BP- 140/90 BP- 130/90
PR- 84 PR- 82 PR- 85 PR- 83
RR- 19 RR- 21 RR- 21 RR- 20
Temp- 36.5 oC Temp- 36.2 oC Temp- 36.4 oC Temp- 36.1 oC
Dx & Lab Procedures
CBC *
U/A *
FBS *
BUN *
Creatinine *
Medical & Surgical
Management
Chest X-ray *
12-L ECG *
O2 inhalation *
D5LRS, 1Lx 30-31 * *
gtts/min
D5NM, 1Lx 30-31 * *
gtts/min
Drugs
H2 Bloc *
 Cefuroxime * * *
Ketorolac * *
Ampicillin * *
Gentamicin * *
MgSO4 * *
Lidocaine * *
Placil * * *
Diet
NPO *
Clear liquid *
Soft Diet *
DAT *
Activity & Exercise
FOB *
Sit on Bed *
Ambulation as Tolerated * *

* First started and indicates the duration it was done and taken.
VIII. DISCHARGE PLANNING

M - Instructed the patient to continue medication as ordered

1. Cephalexin 500 mg cap 3 x day (8am-1pm-8pm) for 1 week
2. Mefenamic Acid 500 mg cap 3 x day (am-1pm-8pm) for 1 week
E - Instructed the patient to do exercise as tolerated such as walking
T - Instructed the patient to continue the medication
H - 1. Encouraged patient to increase fluid intake
2. Encouraged patient to eat foods rich in Vitamin and Nutritious foods
3. Encourage patient to avoid salty and fatty foods
4. Encourage patient to have enough rest
O - Instructed to come back for follow-up check-up on February 23, 2006,
Thursday.
D - Advised the patient to a diet as tolerated but preferably avoiding salty and
fatty foods.
IX. Conclusion
Our patient, Mr. Aproniano Castro has a chief complaint of epigastric pain. He
was admitted in Porac District Hospital and he was diagnosed of having a
cholecystitis with multiple cholelithiasis based on the diagnostic procedure conducted
in him like the CBC, U/A, 12-L ECG, FBS, BUN, Crea, X-ray and UTZ. Due to the
result the surgeon decided for a surgery to remove the gallbladder which is known as
the cholecystectomy. We are happy to say that most of our group mates witness the
operation. The following day we were given the chance to visit and assess our
patient’s condition. Fortunately, the patient had recovered at once he is no longer
complaining of epigastric pain. What he was complaining is if he could already eat
his food for he is on a liquid diet! And of course the pain of his operative site which is
just normal for several days after undergoing the operation.
Since cholecystitis is the inflammation of the gall bladder which is usually
accompanied by gallstones or cholelithiasis these gallstones may block the way of
toxic substances that really needs to go out, but due to this blockage this toxic
substances are not then being expelled and are just being stored in the bladder for a
period of time. This then causes inflammation of the gallbladder. The treatment
usually done is the cholecystectomy.
In order to lower the risk of having this kind of condition each and every one of
us must be conscious in our diet. We should try to avoid foods which are rich in salt
and fats, especially those foods which contains many seasonings. Though there is a
saying that ”Mas masarap pag bawal” which always pertains to the food were eating
we should still be conscious on our health especially if we want to live longer and
also to avoid those life-threatening diseases which not only shorten our life but causes
us some financial problem. Remember also the saying “Mahal ang magkasakit”.
Just like on what our patient had experience he still has to collect money for the
operation he had underwent causing them to have debt with different persons. Let us
not enjoy ourselves with the delicious food were eating that is rich in salts and fats
but we should enjoy living because we have a healthy condition.
 X. BIBLIOGRAPHY

Books

Joyce M. Black,PhD, RN, CPSN, CWCN & Jane Hokanson Hawks, DNSc, RN, BC,
“Medical- Surgical Nursing” 7th edition, pg.1302-1314.

Nursing 2004 Drug Handbook, 24th edition

Doenges, Moorhouse, & Murr,” Nurse’s pocket guide” 9th edition.

Online Resources

www.facs.org

http://tjsamson.client.web-health.com/web-
health/topics/GeneralHealth/generalhealthsub/generalhealth/liver&gallbladder/what_gall
bladder.html

http://www.emedicine.com/emerg/topic97.htm

http://www.emedicine.com/radio/topic163.htm

http://www.healthsystem.virginia.edu/uvahealth/adult_liver/chole.cfm

http://www.emedicine.com/EMERG/topic98.htm

Microsoft Encarta 2004

Nursing Care Plan Content CD-ROM