For a patient evaluated with acute cholecystitis and biliary colic, which nursing diagnosis takes top priority?

• A. Imbalanced nutrition: Less than body requirements related to biliary inflammation
• B. Deficient knowledge related to prevention of disease recurrence
• C. Acute pain related to biliary spasms
• D. Anxiety related to unknown outcome of hospitalization

Answer: (C)

Managing acute pain from biliary colic and gallbladder inflammation is the highest priority. The intense pain from biliary spasms and inflammation not only causes suffering but also triggers a stress response that can raise heart rate, blood pressure, and oxygen demand, potentially worsening dehydration and overall stability. By relieving pain, the patient rests more, breathes more effectively, and remains cooperative with treatment, which supports healing and biliary drainage by reducing ductal spasm. Pain control also makes it possible to tolerate diagnostic tests, procedures, and any needed interventions without added stress.

In practice, this means promptly assessing pain and providing the prescribed analgesia, along with comfort measures such as proper positioning and supportive care. While other nursing concerns like nutritional status, knowledge about prevention of recurrence, and anxiety are important, they are secondary to addressing the immediate pain to prevent further physiologic stress and complications.