OVERVIEW

Definition
Digestive/ Gastrointestinal Disease Involves the formation of pouch-like sacs in the colon or Diverticula (Diverticulosis) Happens when Diverticula are infeted or inflamed

DIVERTICULOSIS DIVERTICULITIS

Etiology
Unknown Raised intraluminal colonic pressure especially in the sigmoid colon Dietary Factors - Lack of Dietary fiber(Low fiber intake)

COLON

SIGNS AND SYMPTOMS Abdominal pain, usually in the lower left side Fever and chills. Bloating and gas. Constipation. Nausea and vomiting.

DIAGNOSTICS Colonoscopy CBC ESR, C-reactive Protein CT Scan (with contrast)

PATHOPHYSIOLOGY

Non-Modifiable Factors Both prevalent in Men and Women 50 y.o. and above Western races

Modifiable Factors Sedentary Lifestyle Dietary Factors Low fiber intake High fat intake Obesity Smoking

ELEVATED INTRALUMINAL PRESSURE

MUSCLES CONTRACT, LUMEN CONSTRICTS

INTESTINE BULGE OUTWARD AT WEAK POINTS (tunica muscularis)

COLONICA MUCOSA HERNIATES THROUGH SMOOTH MUSCLE LAYERS

POUCH-LIKE SACS FORM (DIVERTICULA)

STOOL/FECES LODGES IN DIVERTICULA

BACTERIAL INFECTION
PERFORATION

ABSCESS

DIVERTICULITIS

NURSING MANAGEMENT

1. Administer antibiotics, stool softeners, and antispasmodics, as ordered. For severe pain, administer analgesics as ordered.

2. Maintain bed rest for patient with acute diverticulitis.

3. Maintain liquid diet during the acute attack.

4. If diverticular bleeding occurs, the patient may require

angiography and catheter placement for medication

infusion.

5. When administering medications, monitor the patient for desired effects and possible adverse reaction.

6. Inspect all stools carefully for color and consistency. Note frequency of bowel movements.

7. Monitor the patient for signs and symptoms of complications. Watch for temperature elevation, increasing abdominal pain, blood in stools, and leukocytosis.

8. If the patient has had angiography for catheter placement and vasopressin infusion for diverticular bleeding, inspect the insertion site frequently for bleeding.

9. Instruct the patient to notify the doctor if he has a temperature above 38.3 C.

10. Teach the patient about necessary diagnostic tests and prescribed treatments.

11. If a colostomy is constructed during surgery, teach the patient how to care for it.

12. If the patient expresses anxiety, provide psychological support.