1. The client/caregiver can define function of gallbladder and biliary system.
   1. It is a muscular sac located under the liver.
   2. It stores and concentrates the bile produced in the liver.
   3. It has excess bile that is not immediately needed for digestion.
   4. The bile is released into the small intestine in response to food.
   5. The cystic duct drains the gallbladder. The common bile duct drains into the duodenum. These two ducts form the biliary system.
2. The client/caregiver can define diseases of the gallbladder.
   1. Gallstones are formed in the gallbladder.
   2. They are made up of water, salts, lecithin, cholesterol, and other substances.
   3. They can be of various sizes, ranging from sand size particles to larger than 8 mm.
   4. Biliary colic is when a stone is blocking the opening from the gallbladder.
   5. If the stone blocks the cystic duct for a period of time, acute cholecystitis will occur.
   6. If the blockage persists, bacteria can grow, resulting in cholangitis.
   7. Stones that block the lower end of common bile duct may obstruct secretion from the pancreas and produce pancreatitis.
3. The client/caregiver can describe signs and symptoms of gallbladder disease.
   1. Abdominal pain that
      • Is in the right upper abdomen or the middle of the upper abdomen
      • May be recurrent
      • May be sharp, cramping, or dull
      • May radiate to the back or below the right should blade
      • May be made worse by eating fatty or greasy foods
      • Can occur within minutes of a meal
   2. Jaundice
   3. Fever
   4. Clay-colored stools
   5. Nausea and vomiting
   6. Heartburn
   7. Excess gas
   8. Abdominal fullness
4. The client/caregiver can list teaching needs for clients with gallbladder disease.
   1. Nutrition instructions should include the following:
      1. Understand and follow diet as prescribed. High-fiber and low-fat diets are often recommended (check therapeutic diet chapter).
      2. Eat small, more frequent meals to prevent attacks.
      3. Replacement of water-soluble vitamins (vitamin A, D, E, and K) can sometimes be ordered by physician.
   2. When to contact physician
      • Severe pain
      • Jaundice
      • Fever
      • Changes in color of stool or urine
   3. Take medication as prescribed. Types of medication might include the following:
      1. Pain medication
      2. Medication to relax smooth muscles and spasm of gallbladder
      3. Medication to reduce nausea and vomiting
   4. A follow-up appointment with physician and/or surgeon is given at time of discharge.

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Lutz, C., & Przytulski, K. (2001). Nutrition and diet therapy. Philadelphia: F. A. Davis Company.
Nutrition made incredibly easy. (2003). Philadelphia: Lippincott Williams & Wilkins.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
Taylor, C., Lillis, C., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott, Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com