ACKNOWLEGDEMENT

Without the knowledge that was been shared to us, our case may not be
possible. Despite of the mistakes that have been done, we appreciated the time and
support given to us by those people who helped us to be successful within this case
study.

The group would like to thank the following persons for their support and
cooperation in the completion of this case study:

To Batangas Regional Hospital who gives their place to the nursing students
likes us.

To the staff nurses in Station IV.

To the group’s Clinical Instructor, Mr. Mharlon Melo for guiding and teaching
us the right actions to do. For giving information and additional knowledge to each of
the member. For telling to us that NURSING must be taken seriously because “our
job is not a game because we are handling a one’s life”. For inspiring us to be better
NURSES someday.

To our co-students, friends, and loved ones who lifts us when were down.

To the patient and relatives for being approachable and cooperative to make
our case study successful.

To our parents for supporting our expenses to make this case study
successful. For their unconditional love and support in every trial we have.

Above all, Almighty God for giving us enough wisdom and strength. For giving
a powerful hand in treating our patients. For guiding us and leading to the right one.
For everyday support.

THANK YOU VERY MUCH!!!GOD BLESS YOU ALL!!!

Objectives of the Study

I. General Objectives

This study aims to develop the knowledge, skills and attitudes of student
nurses through effective utilization of nursing process in dealing with the course
treatment of patient with Cholelithiasis.

II. Specific Objectives

At the end of the study, the student nurses will be able to:

1. State the definition of Cholelithiasis.

2. Discuss the patient’s profile, past health history, family history, personal
history, and social history as well as the present illness of the patient.
3. Identify different laboratory examinations done the patient and its significant
findings.
4. Describe the specific organ that is affected by the disease and its function.
5. Discuss the pathophysiology of the disease.
6. Utilize the nursing process as a baseline guide for the delivery of health care
to the patient.
7. Enumerate and discuss the different drugs that were administered to the
patient.
8. Provide information of the prognosis of the diseases of the patient.
9. Discuss the discharge planning.
Lyceum of the Philippines University-Batangas

College of Nursing
In Partial Fulfillment

in

Clinical Area

Submitted by:

Celis, Leo Andrew

De leon, Charline
Panganiban, Mhyliss
Ramirez, Mae Ann Joy
Ramos, Louzelle
Zamonte, Mark Paul M.

BSN III-C /Group B

Submitted to:

Mr. Mharlon Melo

Clinical Instructor

July 31, 2009

BIBILIOGRAPHY

>Laboratory Tests & Diagnostic Procedures by Cynthia C. Chernecky & Barbara

J. Berger (5th edition)

>Laboratory Tests & Diagnostic Procedures in Medicine by John H. Dirckx, M.D.

>Nurses pocket Guide, Diagnoses, Prioritized Interventions and Rationales by

Marilynn E. Doenges, Mary Frances Moorhouse, and Alice C. Murr (11th edition)

>Fundamentals of Nursing Concepts, Process, and Practice by Barbara Kozier,

Glenora Erb, Audrey Berman, and Shirlee Synder (7th edition)

>davi's drug guide for nurses by: judith hopfer deglin & april hazard vallerand (9th
edition)

>Textbook of Medical-Surgical Nursing 11th edition

>world wide web(www)

 INTRODUCTION

Cholelithiasis is the fifth leading cause of hospitalization among adults.

The disease may also be occurring in persons who are obese, who have high
cholesterol, or who are on cholesterol lowering drugs. In most cases, gallbladder
and bile duct diseases occur during middle age. Between ages 20 and 50,
they're six times more common in women, but incidence in men and women
becomes equal after age 50. Incidence rises with each succeeding decade.
Diseases of the gallbladder and biliary tract are common and painful conditions
that may be life threatening and mostly require surgery. They are generally
associated with deposition of calculi and inflammation.

This condition occurs when stones pass out of the gallbladder and lodge
in the hepatic and common bile ducts, obstructing the flow of bile into the
duodenum. Cholangitis, infection of the bile duct, is commonly associated with
choledocholithiasis. Predisposing factors may include bacterial or metabolic
alteration of bile acids. Cholecystitis, acute or chronic inflammation of the
gallbladder is usually associated with a gallstone impacted in the cystic duct that
may cause painful distention of the gallbladder. Postcholecystectomy syndrome
commonly results from residual gal1stones or stricture of the common bile duct. It
may be occurs in 1 % to 5 % of all patients whose gallbladders have been
surgical1y removed and may produce right upper quadrant abdominal pain,
biliary colic, dyspepsia and indigestion.

Gallstones develop in many people without causing symptoms. The

chance of symptoms or complications resulting from cholelithiasis is about 20%.
With current surgical approaches, the outcome is excellent with no recurrence of
symptoms in over 99% of individuals.

We have chosen this case not only because it is only the choice but
somehow, we observed and noticed that during our ages, 20-60,we can have
this. And for further knowledge to control the number of the case, that will start on
us even though we are just student nurses.
 DISCHARGE PLANNING

M- Instructed patient to continue medication as ordered

1.
2.

E- Instructed the patient to do exercise as tolerated such as walking

T- Instructed the patient to continue the medication

H- 1. Encouraged patient to increase fluid intake

2. Encouraged patient to eat foods rich in vitamin and nutrition foods
3. Encourage patient to avoid salty and fatty foods
4. Encouraged patient to have enough rest

O- Instructed to come back for follow-up check-up on ___________

D- Advised the patient to a diet as tolerated but preferably avoiding

salty and fatty foods.

S-