Which of the following factors should be the main focus of nursing management for a client hospitalized for cholecystitis?
A. Administration of antibiotics.
B. Assessment for complications.
C. Preparation for lithotripsy.
D. Preparation for surgery.
Correct Answer: B. Assessment for complications.
The client with acute cholecystitis should first be monitored for perforation, fever, abscess, fistula, and sepsis. Review signs and symptoms requiring medical intervention: recurrent fever; persistent nausea and vomiting, or pain; jaundice of skin or eyes, itching; dark urine; clay-colored stools; blood in urine, stools, vomitus; or bleeding from mucous membranes.
Option A: After an assessment, antibiotics will be administered to reduce the infection. Occlusion of the cystic duct or malfunction of the mechanics of gallbladder emptying is the pathophysiology of this disease. Cases of acute untreated cholecystitis could lead to perforation of the gallbladder, sepsis, and death.
Option C: Lithotripsy is used only for a small percentage of clients. The preferred recommended treatment is the removal of the gallbladder. In the past, this was done through an open laparotomy incision. Now laparoscopic cholecystectomy is the procedure of choice. This procedure has low mortality and morbidity, a quick recovery time (usually one week), and good results.
Option D: Surgery is usually done after the acute infection has subsided. The most appropriate management of cholecystitis is laparoscopic cholecystectomy. There are low morbidity and mortality rates with quick recovery. This can also be done with an open technique in cases where the patient is not a good laparoscopic candidate.
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