a. Cholelithiasis, the presence of calculi or stones in the gallbladder, is the cause of 90 percent of gallbladder disease.

Their presence indicates some dysfunction of the gallbladder. Gallstones are composed of cholesterol, calcium, bilirubin, and inorganic salts.

b. Cholecystitis, inflammation of the gallbladder, is usually associated with gallstones.

c. Biliary colic, or a “gallbladder attack,” is the result of contracture of the gallbladder. Stimulated by fat (from a meal), the gallbladder attempts to release bile, but is unable to do so because of some obstruction. In most cases, this obstruction is due to gallstones. Symptoms of the classic gallbladder attack include the following:

(1) Acute RUQ pain. Pain may radiate to the chest or the upper back.

(2) Nausea and vomiting.

(3) Diaphoresis.

(4) Chills.

(5) Low-grade fever.

d. Nursing implications.

(1) Dietary modifications that decrease fat consumption are used to prevent attacks. (Fatty foods are likely to precipitate an attack.)

(2) Surgery (usually cholecystectomy) is the treatment of choice. Nursing care will therefore focus on postoperative care and observation.