A> Risk for Imbalanced nutrition: less than body req r/t prescribed dietary restrictions, nausea and

impaired fat digestion due to obstruction of bile flow

O>nausea >On NPO With slowed movements Abd cramping after eating Appears weak Increase metabolic need due to illness Pale conjunctiva For open cholecystectomy (9/16/11)

Within 72 hrs,.. the patient will be able to demonstrate

a. Eating small frequent meals in a day b. Showing interest in food c. no signs or symptoms of malnutrition by time of discharge from treatment d. Client will demonstrate regular, independent, nutritional eating habits STO
1.client will consume at least 75% of food at mealtimes
Report relief of nausea

outcome criteria (eval Client is able to verbalize importance of adequate nutrition and fluid intake.

5. monitor and record:

Fluid and food intake Vital signs Elimination pattern

Consult with client about likes/dislikes, foods that cause

distress, and preferred meal schedule.

Set limits on all exercise but allow daily activity. Supervise all activities immediately before and after meals; maintain supervision consistency.
Provide a pleasant atmosphere at mealtime; remove noxious stimuli. Provide oral hygiene before meals. Assess for abdominal distention, frequent belching, guarding, reluctance to move. Ambulate and increase activity as tolerated.

Ensure that client receives small, frequent feedings, including a bedtime snack, rather than three larger meals.

Discourage beverages that are caffeinated or carbonated.

Encourage client to increase fluid consumption and physical exercise to promote normal bowel functioning.