Acute Diverticulitis Essay

976 words - 4 pages

On my third day of clinical course I had an African America patient age 72, female, a retired high school teacher who was admitted for an Acute Diverticulitis with Perforation. She is diabetic and had a medical and surgical history of diverticulitis, High Cholesterol, Non-Insulin-Dependent Diabetes Mellitus (NIDDM), Hysterectomy, and Scoliosis. She has been on clear liquid diet since she was admitted then she was Nothing by Mouth NPO for the CT scan for that day. When I got the assignment that I was going to be taking care of a patient with an acute diverticulitis, the first thing on my mind was that she will be in a severe abdominal pain, high fever due to infection because my aunty had same disease. To my surprise, she claimed a 0 /10 on a 0-10 pain scale. Her blood sugar and vital signs were normal except for respiratory that was 22. All her laboratory test results were normal including WBC. Patient concern was that she couldn’t have a bowel movement. She was medicated on Colace- a stool softener, morphine for pain, sulfran for nausea, and azactam an antibiotics.

Diverticulosis is a disease from the diverticulum. This is when the colon wall is been outpunched through the mucosa. These are small mucosal herniation bulging via smooth muscle and layers of the intestine along vasa recta formed opening in colon’s wall. Diverticulitis causes is still unknown but develop after a micro or macro perforation of diverticulum. Peritonitis is an end result from an intestinal rupture in the case of a large perforation. Clinically, diverticulosis could be asymptomatic or symptomatic, they are uncomplicated with no evidence of bleeding or inflammation. Signs and symptoms includes palpable mass and tenderness mostly in the left lower quadrant, bowel sounds might be hyperactive or hypoactive, and distention in the abdomen. Patient might experience mild or sever pain, crampy, and aching that is similar to appendicitis. Passing of gas or stool elimination may reduce the adverse effect of pain. According to spivak & deSouza (2008), patient that are of high risk are those with the history of low-fiber diet, constipation, high intake of red meat, severe dehydration, and aging. The diagnostic tests are barium enema which determines number of diverticula, CBC indicates present of anemia, colonoscopy exposes present of diverticula, CT scan reveals changes in the colon wall, GI bleeding scan that identifies active bleeding, and CBC with differential reveals leukocytosis.

Wilcox (2009) compared various types of diverticular syndromes and their treatments. He found out that the treatment for the asymptomatic that is characterized by no clinical symptoms and symptomatic which has no inflammation but abdominal pain with change in bowel habits are high-fiber diet. Marinella (2010) found that for uncomplicated diverticulitis, with fever and abdominal pain can be treated with oral antibiotics, bowel rest, clear liquid diet and total...

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