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Nursing Care Plan for Diverticulosis / Diverticulitis

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Pathophysiology

Diverticulosis: A benign condition where pouches form along the intestine wall. These pouches may form anywhere along the intestine, but are most commonly found at the end of the descending and sigmoid colons on the left side of the abdomen. They are also commonly found in the first section of the small intestine, but diverticula in this area rarely cause problems. Diverticulitis: involves small abscesses or infection in one or more of the diverticula, or perforation of the bowel.

Etiology

Diverticulosis– The thickening of the outer wall of the intestine causes narrowing of the inner space. This narrowing causes stool to move more slowly. Hard stools, produced from a low fiber diet, and slower transit time through the intestine create pressure on the intestinal wall, thus forming pockets called diverticula. These pockets are most often asymptomatic. Diverticulitis- Stool passing slowly through the intestine deposits fecal material in the diverticula. Over time, bacterial overgrowth causes an inflammatory response and may form an abscess or infection in the diverticula. Advanced diverticular disease can result in perforations of the intestine and peritonitis if infection is leaked through the perforations into the abdominal cavity.

Desired Outcome

Patient will be free from pain and infection and will be compliant with appropriate diet and medication regimen.

Diverticulosis / Diverticulitis Nursing Care Plan

Subjective Data:

  • Severe abdominal pain / cramping in LLQ
  • Abdominal bloating
  • Nausea / vomiting
  • Constipation
  • Abdominal tenderness

Objective Data:

  • Fever / chills
  • Vomiting
  • Leukocytosis
  • Guarding of abdomen
  • Evidence of diverticula on colonoscopy
  • Possible bloody stools

Nursing Interventions and Rationales

  • Monitor vital signs
  Fever / chills are signs of infection and possibly early peritonitis  
  • Provide Bowel Rest
  Maintain NPO status during initial phase of antibiotic treatment to kill infection and help bowel rest As symptoms decrease, advance diet to clear liquids and then increase fiber slowly.  
  • Assess abdominal pain
  Detailed abdominal assessments will indicate if inflammation or infection may be developing. For example, a rigid abdomen may indicate peritonitis.  
  • Monitor hydration status
  Maintain optimal hydration for improved intestinal motility to prevent constipation  
  • Administer medications
 

  • Antibiotics – for infection
  • Analgesics – for pain
  • IV Fluids – for hydration and bowel motility
  • Psyllium – (bulk-forming laxative) absorbs water from the intestine and makes stool easier to pass

 

  • Provide nutrition education
 

  • Hydrate (2-3 L fluids daily, unless contraindicated for renal or cardiac disease) to avoid constipation
  • Probiotics – to help regulate the intestinal bacteria
  • Avoid foods that trigger flare up (low-fiber foods)

 


References

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  • Question 1 of 5

The client has an acute flare up of diverticulitis. Nursing interventions to prevent complications include which of the following? Select all that apply.

  • Question 2 of 5

The dietary plan for a client with diverticulitis includes which of the following?

  • Question 3 of 5

The nurse is caring for a client who is newly diagnosed with diverticulosis. The nurse explains that an important difference between diverticulosis and diverticulitis is which of the following?

  • Question 4 of 5

The nurse is reviewing medications ordered for a client with diverticulitis. Which of the following medications would the nurse question?

  • Question 5 of 5

The nurse is providing teaching about nutrition to a client with diverticulitis. Which of the following statements is NOT an appropriate teaching point?

Module 0 – Nursing Care Plans Course Introduction
Module Obstetrics (OB) & Pediatrics (Peds) Care Plans

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