Need a bit of assistance regarding cholecystitis.

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Specializes in ICU, Emergency Department.

I have to do a D-Record (Diagnosis Record) on cholecystitis which is basically an outline of the pathophysiology, s&s, treatments, assessments, adaptations and three possible nursing diagnoses. This is not on a specific patient, but on cholecystitis itself.

So for for my NDs I have Acute pain r/t inflammatory process s/t cholecystitis and Deficient knowledge about self-care activities r/t dietary modifications. I'm having a lot of trouble coming up with a second physiological ND. Any ideas?

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Specializes in med/surg, telemetry, IV therapy, mgmt.

nursing diagnoses are based upon symptoms. is pain the only symptom of cholecystitis that you found? hmmm. . .

  • pain and tenderness over the gallbladder which increases on inspiration
  • pallor
  • diaphoresis
  • fever
  • jaundice
  • tachycardia
  • hypoactive bowel sounds

your assessment should include:

  • sudden onset of severe steady or aching pain in the midepigastric region or the right upper abdominal quadrant
  • pain radiating to the back, between the shoulder blades or over the right shoulder blade, or just to the shoulder area
  • attack occurring after eating fatty meal or a large meal after fasting for an extended time
  • attack occurring in the middle of the night
  • nausea, vomiting and chills
  • low grade fever
  • history of milder gi symptoms that preceded the acute attack, indigestion, vague abdominal discomfort, belching, and flatulence after eating high-fat meals or snacks
  • page 178-9, nurse's 5-minute clinical consult: diseases from lippincott williams & wilkins, 2007

you can find weblnks with information about the signs and symptoms and treatments for cholecystitis from the listings on this thread: https://allnurses.com/forums/f205/medical-disease-information-treatment-procedures-test-reference-websites-258109.html. you can find some information on the pathophysiology on the emedicine website (it's listed on the link in front). did you look up the pathophysiology of inflammation? it is detailed here on this thread: https://allnurses.com/forums/f50/histamine-effect-244836.html

nursing interventions will be based on the same signs and symptoms that the doctors also treat.

if you are going to use deficient knowledge (specify), you must specify in the diagnostic label what subject you are addressing. in this case, deficient knowledge, dietary modifications r/t lack of information. the nanda definition of this diagnosis is absence or deficiency of cognitive information related to a specific topic (page 130, nanda-i nursing diagnoses: definitions & classification 2007-2008). the way you have constructed your diagnostic statement (deficient knowledge about self-care activities r/t dietary modifications) is incorrect. what follows the "r/t" part of the diagnostic statement is the etiology, or cause, of the problem (nursing diagnosis). dietary modifications cannot be the cause of the knowledge deficit. it doesn't make sense.

you need a nursing diagnosis reference to help you choose nursing diagnoses. every nursing diagnosis has a list of symptoms just like every medical diagnosis has a list of symptoms. a nursing diagnosis reference will list these symptoms. here are webpages that have the nursing diagnosis information for acute pain ([color=#3366ff]acute pain) and deficient knowledge (specify) ([color=#3366ff]deficient knowledge (specify)).

other nursing diagnoses you can use based on the symptoms are

  • nausea r/t indigestion
  • hyperthermia r/t inflamed gallbladder

there is information on writing a care plan (which is basically what you are being asked to do here although some would call it a case study) on this sticky thread:

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