Diverticulitis, a diverticular disease, nursing NCLEX review of diverticulosis, diverticulitis symptoms, diet, treatment, and nursing interventions. Diverticulosis is the formation of hollow sac cavities throughout the intestinal wall. These outpouching sacs can form anywhere throughout the intestine but are most commonly found in the sigmoid colon of the large intestine.
Diverticulitis is a complication from diverticulosis and occurs when several diverticula or single diverticulum become inflamed, hence why it is known as diverticulITIS. Other complication that can arise from diverticulosis are diverticular bleeding, fistula formation (most commonly of the bladder), and strictures. Diverticular bleeding is due to the rupturing of an artery that surrounds the diverticulum.
When diverticulitis occurs it can lead to abscess formation, peritonits, sepsis, bowel obstruction, and fistula formation. Nursing interventions for diverticulitis included monitoring gastrointestinal system for complications such as peritonitis and following physician’s orders for diet guidelines.
During the initial phase of diverticulitis, when the patient is experiencing signs and symptoms, the patient will be nothing by mouth until the symptoms have decreased. In addition, the nurse will be responsible for administering IV or oral antibiotics along with IV solutions.
During the recovery phase, as the signs and symptoms decrease, the patient will be started on clear liquids. If tolerated, the physician may order the patient to be advanced to a low-fiber diet and to consume plenty of fluids (unless the patient has a condition that restricts fluid intake, such as heart or renal failure). This is the only time a patient with diverticulosis should on a low-fiber diet. A low-fiber diet will allow the bowel to rest and heal. Low-fiber foods include white rice, cooked/skinned vegetables and fruits, eggs etc.
Once full healing has occurred the patient will need to consume a high-fiber diet which should include raw fruits and vegetables, grains like bran, oatmeal, and beans. High-fiber foods will keep the stool soft and bulky, hence prevent constipation. It is important to prevent constipation in a patient with diverticulosis because theories suggest constipation and straining during a bowel movement increases colon pressure which leads to diverticulitis. In addition, the physician may prescribe the patient to take Psyllium (Metamucil) which is a fiber supplement to keep stool soft. Psyllium works be removing water from the intestine and allows for the stool to be softer. New research now suggests it is okay for patients with diverticulosis to consume seeds or nuts. However, it is always important to follow your GI doctor’s recommendations.
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