T-tube Care and Nutrition for Gallbladder Disease

T-tube Care

• Ensure proper connection to sterile container, keeping the tube below the surgical wound level.
• This promotes bile flow and prevents backflow or skin irritation from bile.
• Monitor T-tube drainage color and consistency, recording it as output.
• Normal drainage is up to 500 mL within the first 24 hours, decreasing to less than 200 mL in 2-3 days.
• Initial drainage can be blood-tinged, changing to greenish brown.
• Report excessive drainage immediately, especially if exceeding 500 mL after 48 hours.
• Place the patient in Fowler position to promote gravity drainage of bile.
• Assess skin for bile leakage during dressing changes.
• Use barrier products for skin protection as bile irritates the skin.
• Teach the patient to manage the tube while turning, ambulating, and performing daily tasks.
• Avoid pulling or traction on the tube.
• Teach the patient to care for the T-tube, clamp it, and recognize infection signs if needed.

### Nutrition for Gallbladder Disease

• Assess nutritional status due to potential nutritional deficiencies caused by gallbladder disease.
• Evaluate laboratory results like serum bilirubin, albumin, glucose, and cholesterol levels.
• Elevated serum bilirubin indicates impaired bilirubin excretion due to obstructed bile flow.
• Low serum albumin suggests poor nutritional status.
• Glucose intolerance and hypercholesterolemia are risk factors for cholelithiasis.
• Refer the patient to a dietitian for diet counseling to promote healthy weight loss and reduce pain.
• A low-carbohydrate, low-fat, higher-protein diet reduces cholecystitis symptoms.
• Encourage moderate calorie reduction and increased activity for weight loss.
• Help the patient manage dietary restrictions.
• Administer vitamin supplements as ordered.
• Fat-soluble vitamin supplements may be required due to impaired fat absorption.