8/14/2019 ACUESTAS, REX TIMOTHY B. Anatomy and Physiology Gall Bladder

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ACUESTAS, REX TIMOTHY B. 3II2

Anatomy and Physiology

Gall bladder

A pear-shaped organ that lies just below the liverand is attached to

the visceral surface of the liver by the cystic duct. The main

function of the gall bladder is to store the bile that is secreted by

the liver. In the gall bladder, the bile is concentrated by the

reabsorption of water from it. When fatty food is digested, the gall

bladder contracts, thus delivering bile through the bile ducts to the small intestine where it is able to help dissolve

fats.

The most common disorder of the gall bladder is gallstones, which are composed ofcholesterol crystals orpigment

material.

What are the indications for cholecystectomy?

Cholecystectomy is indicated in the presence of gallbladder trauma, gallbladder cancer, acute cholecystitis, and

other complications of gallstones. More controversial are the indications for elective cholecystectomy. To properly

determine the indications for elective cholecystectomy, the risk of the operation (taking into account the age and

comorbid factors of the individual patient) must be weighed against the risk of complications and death without

operation (taking into account the symptomatic status of the individual and the functional status of the gallbladder).

Cholecystectomy (or some other form of gallstone therapy) is indicated in most patients with symptomatic

cholelithiasis--especially those with non-functioning gallbladders. Cholecystectomy is not indicated in most patients

with asymptomatic stones.

Nursing Intervention

ACTIONS/INTERVENTIONS

Independent

Monitor I&O, including drainage from NG tube, T-tube,

and wound. Weigh patient periodically.

Monitor vital signs. Assess mucous membranes, skin

turgor, peripheral pulses, and capillary refill.

Observe for signs of bleeding, e.g. , hematemesis, melena,

petechiae, ecchymosis.

http://www.daviddarling.info/encyclopedia/L/liver.htmlhttp://www.daviddarling.info/encyclopedia/B/bile.htmlhttp://www.daviddarling.info/encyclopedia/B/bile_duct.htmlhttp://www.daviddarling.info/encyclopedia/S/small_intestine.htmlhttp://www.daviddarling.info/encyclopedia/F/fat.htmlhttp://www.daviddarling.info/encyclopedia/G/gallstone.htmlhttp://www.daviddarling.info/encyclopedia/C/cholesterol.htmlhttp://www.daviddarling.info/encyclopedia/P/pigment.htmlhttp://www.daviddarling.info/encyclopedia/B/bile.htmlhttp://www.daviddarling.info/encyclopedia/B/bile_duct.htmlhttp://www.daviddarling.info/encyclopedia/S/small_intestine.htmlhttp://www.daviddarling.info/encyclopedia/F/fat.htmlhttp://www.daviddarling.info/encyclopedia/G/gallstone.htmlhttp://www.daviddarling.info/encyclopedia/C/cholesterol.htmlhttp://www.daviddarling.info/encyclopedia/P/pigment.htmlhttp://www.daviddarling.info/encyclopedia/L/liver.html

8/14/2019 ACUESTAS, REX TIMOTHY B. Anatomy and Physiology Gall Bladder

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Use small-gauge needles for injections, and apply firm

pressure for longer than usual after venipuncture.

Have patient use cotton/sponge swabs and mouthwash

instead of a toothbrush.

Collaborative

Monitor laboratory studies, e.g., Hb/Hct, electrolytes,

prothrombin level/clotting time. Administer IV fluids, blood products, as indicated;

Electrolytes;

Vitamin K.

Nursing Diagnosis

Pre-op nursing diagnosis

Knowledge deficit

Post-op nursing diagnosis

risk for impaired liver functioning related to gallbladder removal surgery

acute pain related to gallbladder removal surgery