Gallstones 
Definition
a small, hard crystalline mass formed abnormally in the gall bladder or bile ducts from bile pigments, cholesterol, and calcium salts
Causes
Signs and symptoms
Vomiting
Pain in your right shoulder
Nausea
sudden and rapid pain in the centre of you abdomel
pain in the upper belly and upper back that last for hours
your genes
your weight (obesity)
Problems with gallbladder
Diet
Fasting
Phathophysiology
The first is how often and how well the gallbladder contracts; incomplete and infrequent emptying of the gallbladder may cause the bile to become overconcentrated and contribute to gallstone formation
This can be caused by high resistance to the flow of bile out of the gallbladder due to the complicated internal geometry of the cystic duct
Besides a high concentration of cholesterol, two other factors are important in causing gallstones.
The second factor is the presence of proteins in the liver and bile that either promote or inhibit cholesterol crystallization into gallstones.
Cholesterol gallstones develop when bile contains too much cholesterol and not enough bile salts
Diagnosis procedure
X-ray plain
ERCP and MRCP
Abdominal ultrasound
Murphy's signs
Blood test
Nursing management
promote comfort to relieve pain stimulus
do oral care before meals to avoid vomiting
Administer prescribed medication accordingly
promote rest and allow for uninterrupted periods of relaxation during the acute phase of illness
Pharmacological therapy
nonsurgigal treatment option involve injecting a solvent known as methyl tertiary-butyl ether(MTBE) into the gall bladder to dissolve gallstones
Percutaneous cholecystomy
Acid pills that can dissolve gallstones such as ursodiol
Morphine for pain
Diet
eating nuts
full healthy balanced diet
Increase fibre intake
increase vitamin c intake
Increasing dietary calcium