BY: CLARISSA E.

GUIFAYA
BSN301/GROUP 3
• Diverticulosis
happens when
pouches (diverticula)
form in the wall of
the colon. If these
pouches get inflamed
or infected, it is
called diverticulitis.
Diverticulitis can be
very painful.
MEDICAL
PRACTITIONERS DOES
NOT KNOW THE
CAUSE OF
DIVERTICULITIES YET,
BUT IT CAN BE
ASSOCIATED WITH:
• LOW-FIBER DIET
• CONSTIPATION
• FREQUENT
STRAINING OF
BOWEL MOVEMENT
 The patients that are at the highest risk for
developing diverticulitis are:
o Older patients
o Smoking
o Sedentary lifestyle (lack of exercise).
o Obesity
o Diet that is low in fiber and high in animal fat
o Some medications (steroids, opiates, and non-steroidal
anti-inflammatory drugs).
Formation or hardened
mass stool (Fecalith)

Increase intraluminal
pressure

Decrease muscle strength

in colon
Nausea and vomiting

Formation of diverticula
Rebound peristalsis

Retention of fecal material Obstruction Abdominal distention

Constipation
Decrease blood supply
Decomposing of fecal
material

Infection Bacterial Translocation Peritonitis

Secretion of toxins

Inflammatory process Nausea and Vomiting

Secretion of neutrophils
and microphages

Fever Loss of appetite Malaise

• Blood tests
• Pregnancy test
• Liver function test
• Stool cultures
• CT scan
• Abdominal ultrasound
• Patients with a history of diverticulosis usually
have no signs or symptoms of illness. When
symptoms do appear, they are severe and
have a fairly sudden onset.
• Abdominal tenderness
• Gas
• Bloating
• Fever
• Nausea and or vomiting
• Decreased appetite
• Antibiotics-for infection
• Pain medications
• Bed rest
• Bowel rest ( liquid diet for 1-2 days)
• Increase more fiber to diet
• Primary bowel resection. The surgeon
removes diseased segments of your intestine
and then reconnects the healthy segments
(anastomosis).
• Bowel resection with colostomy. If you have
so much inflammation that it's not possible to
rejoin your colon and rectum, the surgeon will
perform a colostomy.
• Acute Pain
Interventions
Assess level of pain using appropriate
pain scale. Assess pain 30 minutes
before and after pain medication is
given.
Administer pain medications as
prescribed and indicated.
Check for number of bowel movements
at least once per shift.
Incorporate nonpharmacologic
measures to assist with control of pain.
Rationale
Using an appropriate age pain rating
scale will help the healthcare providers
monitor the level of pain and adjust pain
medications as needed.
Analgesics are helpful in relieving pain
and helping in the recovery process.
Immobility caused by pain may
decrease the parasympathetic
stimulation to the bowel.
Ideally, the use of comfort measures
will distract the patient from pain and
may increase the effectiveness of
pharmacological measures.
• Risk for Infection
Interventions
Assess vital signs including
temperature every 4 hours and as
needed. Report any abnormal findings
to the healthcare provider.
Assess mental status and level of
consciousnesses every 4-6 hours.
Report and note any abnormal
laboratory values (i.e. elevated WBC
count) to the healthcare provider.
Rationale
Fever is often one of the first signs of
infection.
Mental status changes, confusion, or
any deterioration from baseline can
signify infection.
Certain abnormal laboratory results
could be an indicator of infection.
 • Moxiflaxacin
Mechanism of Action
Moxifloxacin is a broad-
spectrum antibiotic that is
active against both Gram-
positive and Gram-negative
bacteria. It functions by
inhibiting DNA gyrase, a type
II topoisomerase, and
topoisomerase IV, enzymes
necessary to separate bacterial
DNA, thereby inhibiting cell
replication.
Side Effects Nursing Responsibilities
• Nausea Assessment
• Diarrhea • Monitor therapeutic
• Dizziness effectiveness indicated by
• lightheadedness clinical improvement of
• Headache infection.
• Weakness • Notify physician immediately
• trouble sleeping for S&S of hypersensitivity
(see Appendix F).
• ampicillin/sulbactam
Mechanism of Action Side Effects Nursing Responsibilities

Drug combination of beta- Candidiasis Assessment

lactamase inhibitor with Chest pain • Determine previous
ampicillin; interferes with Chills hypersensitivity reactions to
bacterial cell wall synthesis Dysuria penicillins, cephalosporins,
during active replication, Edema and other allergens prior to
causing bactericidal activity Erythema therapy.
against susceptible organisms; Fatigue • Report promptly
alternative to amoxicillin when Headache unexplained bleeding
unable to take medication Itching • Observe for and report
orally; covers skin, enteric Malaise symptoms of
flora, and anaerobes; not ideal Mucosal bleeding superinfections (see
for nosocomial pathogens. Nausea Appendix F). Withhold drug
Seizure and notify physician.
Vomiting • Monitor I&O ratio and
pattern. Report dysuria,
urine retention, and
hematuria.
• http://nursingcrib.com/drug-guides/ampicillin-sodium-
and-sulbactam-sodium/
• http://nursingcrib.com/drug-guides/moxifloxacin/
• https://www.webmd.boots.com/digestive-
disorders/understanding-diverticulitis-symptoms
• https://www.webmd.com/digestive-
disorders/tc/diverticulitis-topic-overview#1
• http://nursestudy.net/2015/04/02/diverticulitis-
pathophysiology-podcast-and-nursing-care-plan/
• https://www.mayoclinic.org/diseases-
conditions/diverticulitis/basics/treatment/con-
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