Question

Sam, presents at the clinic after a CT scan of the abdomen with contrast was positive for diverticulitis is 40. The patient presents with nausea, vomiting, fever, and chills; left lower quadrant abdominal pain described as spasms; and a firm mass. Bowel sounds are present in all 4 quadrants. The patient reports bouts of constipation with a hard narrow stool that is difficult to pass and periods of diarrhea with abdominal cramping. The stool is negatve for occult blood. The patient has no other medical conditions. The vital signs include: BP 110/70, P 100, R 22, and T 101 F. The white blood count and ESR are elevated. The physician orders a broad spectrum antibiotic, amoxicillin clavulanate for 10 days, and propantheline Bromide(Pro-Banthine) before meals and at bedtime, psyllium(metamucil), and docusate sodium(colace). Diet is as follows: clear liquids until inflammation subsides for 24 to 48 hours, and then advance diet, as tolerated, increasing the intake of fresh fruits and vegetables at least 5 servings per day, and bran cereal everyday. The patient is also instructed to eat whole grain bread.

A-what questions should the nurse ask the patient while taking a history?

B-what patient education should the nurse provide to the patient being treated for diverticulitis on an out patient basis?

Answer 1

A) The nurse has to ask

Age

  Habits of smoking

  Physical inactivity- what type of job the patient is doing

History of medication use such as steroids, NSAIDs

Bowel habits; Constipation or diarrhea history

Pattern of stomach pain

BMI - bacause obesity is one of the risk factors.

Dietary pattern- low fibre intake

These are the risk factors of diverticulosis. so the nurse have to ask these history.

B. Advice:

As mentioned liquid diet for 1-2 days. After that gradual solid diet.

Take much more fibre rich food items. such as fresh fruits and vegetables

Improve physical activity

Cessation of smoking, if have that habit.

Take antibiotics and other medications as per order.

If have fever, stomach pain and constipation or diarrhea not subside consult doctor.

After completion of medication course, consult doctor and take CT scan again .

To avoid recurrence take dietary fiber rich foods, regularize bowel habits.

Taking probiotics and prebiotics may sometimes helpful