Risk for Imbalanced Nutrition: Less than Body Requirements | NCP for Cholecystitis

Risk factors may include
Self-imposed or prescribed dietary restrictions, nausea and vomiting, dyspepsia, pain
Loss of nutrients; impaired fat digestion due to obstruction of bile flow

Possibly evidenced by
(Not applicable; presence of signs and symptoms establishes an actual diagnosis)

Desired Outcomes/Evaluation Criteria—Client Will
Nutritional Status
Report relief of nausea and vomiting.
Demonstrate progression toward desired weight gain or maintain weight as individually appropriate.

Nursing intervention with rationale:
1. Estimate or calculate caloric intake. Keep comments about appetite to a minimum.
Rationale: Identifies nutritional deficiencies and needs. Focusing on problem creates a negative atmosphere and may interfere with intake.

2. Weigh, as indicated.
Rationale: Monitors effectiveness of dietary plan.

3. Consult with client about likes and dislikes, foods that cause distress, and preferred meal schedule.
Rationale: Involving client in planning enables client to have a sense of control and encourages eating.

4. Provide a pleasant atmosphere at mealtime; remove noxious stimuli.
Rationale: Useful in promoting appetite and reducing nausea.

5. Provide oral hygiene before meals.
Rationale: A clean mouth enhances appetite.

6. Offer effervescent drinks with meals if tolerated.
Rationale: May lessen nausea and relieve gas. Note: May be contraindicated if beverage causes gas formation with subsequent gastric discomfort.

7. Assess for abdominal distention, frequent belching, guarding, and reluctance to move.
Rationale: Nonverbal signs of discomfort associated with impaired digestion, gas pain.

8. Ambulate and increase activity, as tolerated.
Rationale: Helpful in expulsion of flatus and reduction of abdominal distention. Contributes to overall recovery and sense of well-being and decreases possibility of secondary problems related to immobility such as pneumonia and thrombophlebitis.

9. Consult with dietitian and nutritional support team, as indicated.
Rationale: Useful in establishing individual nutritional needs and most appropriate route.

10. Begin low-fat liquid diet after NG tube is removed.
Rationale: Limiting fat content reduces stimulation of gallbladder and pain associated with incomplete fat digestion and is helpful in preventing recurrence.