Author Question: A nurse is caring for a client with severe acute abdominal pain secondary to cholelithiasis. Which ... (Read 79 times)

geodog55 · **on:** Jun 25, 2018

A nurse is caring for a client with severe acute abdominal pain secondary to cholelithiasis. Which nursing actions promote effective pain management?

Select all that apply.
A) Withhold oral food and fluids.
B) Insert nasogastric tube and connect to high wall suction.
C) Educate the client about decreasing protein in the diet, as protein increases gallbladder contractions.
D) Administer morphine, meperidine, or another opioid analgesic as ordered.
E) Place the patient in supine position to relieve abdominal pain.

Question 2

The nurse is caring for an older adult client with cholecystitis. The client has been admitted to the hospital for diagnostic testing and pain control. Which nursing diagnosis would be a priority for this client?

A) Anxiety
B) Risk for Infection
C) Impaired Comfort
D) Imbalanced Nutrition: Less than Body Requirements

JYan · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Answer: A, D

The pain associated with cholelithiasis can be severe. Nursing interventions that help to promote effective pain management include withholding oral food and fluids and inserting a nasogastric tube connected to low wall suction. The nurse should educate the client about decreasing fat in the diet, as fat entering the duodenum initiates gallbladder contractions, causing pain when gallstones are in the ducts. Administering morphine, meperidine, or another opioid analgesic as ordered aids in pain management. The nurse should place the patient in Fowler position, not supine, to decrease pressure on the inflamed gallbladder.

Answer to Question 2

Answer: B

All of these diagnoses are appropriate for the client with gallbladder disease. However, because the elderly client does not have as effective an immune system as younger clients, the nurse should prioritize care around preventing infection in this client.