Cholecystitis — NCLEX Cheat Sheet
RUQ pain + Murphy's signAlso known as: gallbladder inflammation · gallbladder attack · inflamed gallbladder · gallstones · gall bladder pain
Use this quick-reference guide to spot, treat, and prevent Cholecystitis on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
⚠️ Causes
- Gallstones block cystic duct
- Fat, female, forty, fertile
🩺 Signs
- RUQ pain → right shoulder
- Murphy's sign +, worse w/ fatty
- N/V, fever, clay stool, jaundice
✅ Do
- NPO, IV fluids, pain meds
- Lap cholecystectomy = definitive
- Low-fat diet, small meals
🚩 Report
- T-tube >500 mL/day or no drainage
- Fever, ↑ pain = perforation
📚 Cholecystitis — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Right upper quadrant pain that may radiate to the right shoulder or scapula, often after a high-fat meal.
- Murphy sign is positive: pain and inspiratory arrest when the RUQ is palpated during deep breath.
- Nausea, vomiting, fever, and indigestion (dyspepsia) are common.
- Obstruction of bile flow causes jaundice, dark amber urine, clay-colored stools, and pruritus.
- Bile is needed to absorb fat-soluble vitamins, so deficiency of A, D, E, and K may occur.
- The classic risk profile is the 4 F's: female, forty, fat (obese), and fertile.
Nursing priorities
What to do, in order- Keep the patient NPO during acute attacks to rest the gallbladder.
- Administer prescribed analgesics and antiemetics; provide IV fluids as ordered.
- Prepare and educate the patient for cholecystectomy, often laparoscopic.
- Monitor for signs of bile duct obstruction such as worsening jaundice and pale stools.
- Administer fat-soluble vitamin supplements and vitamin K if bile flow is impaired, as ordered.
Red flags — report now
Escalate immediately- Fever, severe RUQ pain, and jaundice may indicate ascending cholangitis or sepsis requiring urgent care.
- Signs of gallbladder rupture or peritonitis (rigid abdomen, rebound tenderness) need immediate escalation.
- Clay-colored stools with dark urine and worsening jaundice signal complete bile obstruction.
Labs & values
Numbers to know- WBC: 5,000-10,000/mm3 (elevated with inflammation/infection)
- Total bilirubin: 0.3-1.0 mg/dL (elevated with obstruction)
- Alkaline phosphatase and AST/ALT may be elevated
Patient teaching
What patients must know- Eat a low-fat diet and avoid greasy, fried foods that trigger attacks.
- After cholecystectomy, gradually reintroduce fats and report fever, increasing pain, or jaundice.
- Report persistent RUQ pain, fever, or yellowing of the skin and eyes.
❓ Cholecystitis: NCLEX FAQs
What are the priority nursing interventions for Cholecystitis?
Keep the patient NPO during acute attacks to rest the gallbladder. Administer prescribed analgesics and antiemetics; provide IV fluids as ordered. Prepare and educate the patient for cholecystectomy, often laparoscopic. Monitor for signs of bile duct obstruction such as worsening jaundice and pale stools.
What are the warning signs of Cholecystitis a nurse must report?
Fever, severe RUQ pain, and jaundice may indicate ascending cholangitis or sepsis requiring urgent care. Signs of gallbladder rupture or peritonitis (rigid abdomen, rebound tenderness) need immediate escalation. Clay-colored stools with dark urine and worsening jaundice signal complete bile obstruction.
What do I need to know about Cholecystitis for the NCLEX?
Right upper quadrant pain that may radiate to the right shoulder or scapula, often after a high-fat meal. Murphy sign is positive: pain and inspiratory arrest when the RUQ is palpated during deep breath. Nausea, vomiting, fever, and indigestion (dyspepsia) are common. Obstruction of bile flow causes jaundice, dark amber urine, clay-colored stools, and pruritus.
What patient teaching is important for Cholecystitis?
Eat a low-fat diet and avoid greasy, fried foods that trigger attacks. After cholecystectomy, gradually reintroduce fats and report fever, increasing pain, or jaundice. Report persistent RUQ pain, fever, or yellowing of the skin and eyes.
Quick Tip
Right upper quadrant pain that may radiate to the right shoulder or scapula, often after a high-fat meal.
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