Diverticulitis

Diverticulitis

1. Pathophysiology

   • The patient has a diverticulitis and the pathophysiology for diverticulitis is that it is inflammation of one or more diverticula, resulting in perforation into the peritoneum. Diverticula can occur anywhere in the GI tract but are more common in the descending, sigmoid colon. They think that these can occur at the weak points in the intestinal wall. A main cause of diverticulitis is the lack of dietary fiber intake. Inadequate dietary fiber slows transit time, allowing more water to be pulled from the stool.

2. Goals

   • Long Term
     • Patient will be compliant with high fiber diet by end of discharge
       • Partially Met, ongoing. Patient during my time on the unit was following the adhered high fiber diet. I did not see her discharge she will be on the unit for 40 days.
   • Short Term
     • Patient will have stated pain relief of a level 4 or below by end of shift
       • Met, patient reported pain level of 3. Interventions given were position changes to alleviate flank pain. Heat pack, played her favorite music as a diversion.

3. Clinical Manifestations

   • Acute pain in lower left quadrant, palpable abdominal mass, nausea, vomiting, and systemic symptoms of infection. Older adults they may have no symptoms.

4. Diagnostic Studies

   • CT Scan with Contrast. CT scan should outpouchings and inflammation in the intestine, Abdominal X-ray helps rule out other conditions.

5. Significant Labs

   • Her labs were normal.

6. Interventions for the potential nursing diagnosis

   • Advance from clear liquid diet to low residue diet as to help reduce the chance of exacerbation of symptoms, provide pain relief when needed, Monitor I &O Refer to a dietitian to explain the importance of a high fiber diet,

7. Potential Nursing Diagnosis

   • Pain related to inflamed bowel and possible peritonitis • risk for deficient fluid volume related to in flammation • Impaired tissue integrity: Gastrointestinal related to perforated diverticulum • Deficient knowledge related to disease process and dietary management

8. Medications

   • Merrem, Albuterol, Zocar, Vancomycin, Lispro, Hydromorphone

9. Assessment Data

   • Hear rate Regular S1 &S2 Noted Radial and dorsalis pedalis, pulses present , check BS at breakfast, BP 134/74, R-21, O2-99, P 84, T-97.2, Pain 7/10 complains of a dull aching sensation, Lungs clear Bilaterally Chest expansion symmetrical 02 humidified oxygen at 2L via nasal canula Alert, orientated x3, PERRL Equal strength grips Active Bowel Sounds x4 Passing Flatulence. Patient is guarding abdomen. Reports abdomen pain is constant Continent of bowel and bladder. Yellow, clear no odor to urine.