Diverticulosis and diverticulitis concept map PDF

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Disease: diverticulosis and diverticulitis Diverticula: saccular dilations or outpouchings of the mucosa that develop in the colon Diverticulosis: presence of multiple noninflamed diverticula Diverticulitis: inflammation of one or more diverticula, resulting in perforation into the peritoneum Diverticula are common in older adults but most people don’t develop diverticulitis

Etiology: May occur anywhere in GI tract Most are common in the descending and sigmoid colon Occur at weak points in intestinal wall More prevalent in diets low in dietary fiber More prevalent in western, industrialized nations Inadequate dietary fiber slows transit time and allows more water to be absorbed from stool making it more difficult to pass through lumen Decreased stool size increases intraluminal pressure; this places stress on the weakened areas and promotes diverticula formation Uncommon vegetarians: Other risk factors: obesity, inactivity, smoking, excessive alcohol use, immunosuppression

S/S: Majority have no symptoms Abd pain Bloating Gas Changes in bowel habits Diverticular bleeding Diverticulitis: Acute pain in the LLQ(sigmoid colon) Palpable abd mass

N/V Fever Increased c-reactive protein Leukocytosis May be afebrile with normal WBC count and little abd tenderness Erosion of the bowel wall Perforation of peritoneum Localized abscess development Peritonitis Bleeding

dX studies: sigmoidoscopy colonoscopy CT scan Oral contrasts Abd and chest x-ray

Nursing and interprofessional care: table 42-30 High fiber diet Decreased intake of red meat increased physical activity oral antibiotics clear liquid diet NPO status Iv fluids and antibiotics Observe for signs of abscesses, bleeding, peritonitis Monitor WBC count pain management

after acute attack subsides, oral fluids then diet of semisolids fluid intake of at least 2L/ day weight reduction avoid increased intraabdominal pressure such as straining stool, bending, heavy lifting, wearing tigght and restrictive clothing...