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Nurs G140 Exam 3 > Diverticulitis > Flashcards

Diverticulitis Flashcards

1
Q

Role of RN for inflammation

A

collaborate for decrease/elimination of inflammation and maintenance/improvement of function

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2
Q

What is diverticula?

A

saclike herniation of lining of bowels

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3
Q

What is the most common place for diverticulosis to occur?

A

sigmoid colon; may occur in the entire colon and small bowel

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4
Q

What is diverticulitis?

A

inflammation of the diverticula.

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5
Q

symptoms of diverticulosis

A

mostly asymptomatic, history of chronic constipation (irregularity, bloating, distention)

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6
Q

Clinical manifestations of diverticulitis (5)

A
  • left lower quadrant pain/cramps
  • bowel irregularity, intervals of diarrhea, nausea, constipation
  • narrow stools
  • abdominal distension, fatigue, anorexia
  • fever, chills
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7
Q

Clinical manifestations of diverticulitis in the elderly

A

may be asymptomatic, delay for care of fear, overlook blood in the stool

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8
Q

Diverticulitis diagnosis (6)

A
  • colonoscopy (NOT FOR ACUTE DIVERITICULITIS)
  • CT w/ contrast
  • AXR with free peritoneal air
  • elevated WBC, ESR, CRP
  • Hg if blood in stool
  • urinalysis IF colovesicular fistulas
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9
Q

When is a colonoscopy contraindicated?

A

acute diverticulitis

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10
Q

What is the test of choice to diagnose diverticulitis?

A

CT w/ contrast

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11
Q

Complications of diverticulitis (6)

A
  • peritonitis
  • abscesses
  • fistula formation
  • palpable mass
  • fever, leukocytosis, abd pain
  • bleeding
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12
Q

diverticulitis nursing dx (5)

A
  • acute pain
  • activity intolerance
  • deficient fluid volume (anorexia, n/v)
  • risk for dysfunctional gastrointestinal motility
  • risk for infection
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13
Q

Hinchey stage (I), how is it treated

A
  • localized pericolic or mesenteric abscess

- outpatient treatment

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14
Q

Hinchey stage (II), how is it treated

A
  • walled-off pelvic, intra-abdominal, or retroperitoneal abscess
  • may need admission
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15
Q

Hinchey stage (III), how is it treated

A
  • generalized purulent peritonitis

- Admission and surgery

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16
Q

Hinchey stage (IV), how is it treated

A
  • generalized fecal peritonitis

- admission and surgery

17
Q

Conservative therapy for diverticulitis to decrease inflammation and address risk factors (6)

A
  • bedrest
  • clear liquid diet –> high fiber low-fat diet
  • antibiotics 7-10 days (acute diverticulitis)
  • stool softeners, bulk laxatives
  • weight reduction, exercise program
  • Increased fluid intake
18
Q

Acute treatment for severe exacerbation of diverticulitis (6)

A
  • Bedrest
  • NPO with NG tube suctioning or clear liquid diet
  • IV fluids
  • broad spectrum IV antibiotics
  • pain management with opioids
  • low fiber diet until signs of infection decrease
19
Q

Surgical management for diverticulitis (2 surgeries, post op care, ___ care if present)

A
  • intestinal resection (pre-op antibiotics)
  • colostomy
  • post op nursing care: similar to GI surgery: IV fluids, antibiotics, NPO to evolving diet, monitor GI, F&R, I&O
  • stoma care if preset
20
Q

Stoma after surgery

A

-bright red, may be shiny, some blood drainage expected

21
Q

colostomy care (Pt ed) (4)

A
  • dietary changes
  • skin care
  • FE balance
  • colostomy care
22
Q

What does secondary peritonitis result from?

A

it results from the primary disease (ex: diverticulitis)

23
Q

Peritonitis is caused by _____

A

a leakage of abdominal organs’ contents

24
Q

Peritonitis is the leakage of abdominal organ contents possibly from …. (5)

A
  • inflammation
  • Infection
  • Ischemia
  • trauma
  • perforation
25
Q

Assessment and diagnosis of secondary peritonitis (5)

A
  • AXR: free air or fluid, distended bowel loops
  • CT, MRI for abcesses
  • Increased WBC
  • may present decreased H/H
  • electrolyte imbalance
26
Q

complications of secondary peritonitis (4)

A
  • sepsis
  • hypovolemia
  • Intestinal obstruction
  • bowel adhesions
27
Q

Peritonitis: interventions to decrease inflammation (5)

A
  • pain management and infection control (ABX)
  • NPO: NG tube suctioning
  • Monitor VS; prevention of shock, infection/sepsis
  • FE; acid-base balance; treat nausea
  • surgical excision (appendix)/ resection (intestine), repair (perforation), and drainage (abscess)
28
Q

As peritonitis subsides …. (3)

A
  • softening of abdominal wall
  • VSS and toward WNL
  • diet advancement

Nurs G140 Exam 3 (7 decks)

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