N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Nursing interventions for gall bladder disease: • Maintain NPO status until acute attack subsides or surgical intervention is initiated • Give IV fluids to correct or prevent dehydration; electrolytes if needed • If patient does not need surgery, maintain a low-fat diet (avoidance of fried foods, dairy, nuts, chocolate, or heavy foods) • Assess pain frequently and teach non-pharmacological painmanagement • Give patient a warm bath, back rub, and warm blankets for comfort • Give medications per MD order: o Analgesics o Antiemetics o Methyl tertiary butyl ether (MTBE): A solvent that can be put directly into the gallbladder o Oral bile salts • Prepare patient for surgical or other procedures: o Lithotripsy: Shock waves are directed at gallstones to break them up and make them smaller o Choledochostomy: A drain is made in the common bile duct to assist the drainage of bile and keep it out of the peritoneal cavity o Cholecystectomy: Complete surgical removal of the gallbladder; may be done by laparoscope, in which four small incisions are made and the gallbladder is dissected and removed; healing time for this type of surgery is much shorter than with a large incision • Assess for response tomedications • If patient has surgery slowly advance diet from NPO, to clear liquids, and then bland, low-fat diet as tolerated • Patient teaching on continuing a low-fat diet, wound care, medications, and follow-up appointments Expected outcomes for gall bladder disease: • Patient remains free of signs and symptoms of infection • Verbalizes increased comfort and pain relief • Patient remains free of surgical complications • Maintains adequate nutritional status and hydration • Verbalizes an understanding of the disease process, diet modifications, treatment, and recovery plans ©2017 Achieve Test Prep Page 166 of 204