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by krzystjl
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Health & Fitness

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Concept: Elimination

Exemplar: Diverticulitis

*Diverticulitis occurs more often in older adults and affects men more frequently than women.*Diet – low in fiber can increase risk of developing diverticula.

Risk Factors:

Assessment Findings:

*Abdominal pain in left-lower quadrant*Nausea and vomiting*Fever*Chills*Tachycardia

Nursing Care:

*The client is hospitalized when clinical findings are more severe (severe pain, high fever). The client is NPO, has nasogastric suctioning, is receiving IV fluids, IV antibiotics, total parenteral nutrition, and opioid analgesics for pain.*Instruct the client who has mild diverticulitis on self-care at home. The client should take medications as prescribed (antibiotics, analgesics, antispasmodics) and get adequate rest.*Educate the client to consume a clear liquid diet until manifestations subside. The client may progress to a low-fiber diet as tolerated.*Instruct the client to add fiber to the diet once solid foods are tolerated without other manifestations. The client should slowly advance to a high-fiber diet as tolerated.*Teach client to avoid seeds or indigestable material, which can block diverticulum (nuts, popcorn, seeds).*Instruct client to avoid irritating the bowel (avoid alcohol, limit fat to 30% of dailycalorie intake).*Provide client with instructions to promote normal bowel function and consistency (may take bulk-forming laxatives only, drink adequate fluids, avoid use of enemas).



*Refer the client for nutritional counseling.*The client may benefit from complementary therapy (biofeedback, massage, yoga).*The client may need a mental health referral for assistance with coping.

*Surgical Procedures for Diverticulitis (dependent on problem type) ■ Colon resection ■ Double-barrel colostomy, but may be temporary ■ Treatment of complications (peritonitis, abscess, obstruction, fistula, bleeding)


*Complications of diverticulitis include bleeding and fluid andelectrolyte imbalance. Peritonitis may occur due to perforation of the bowel. Abscess formation may also occur as a complication of diverticular disease.

Assessment Technologies Institute (ATI). LLC. (2013). RN Adult medical surgical nursing content mastery series review module (Edition 9.0). ATI.


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