Diverticulitis is the inflammation or infection of small pouches, called diverticula, that form in the walls of the colon. These pouches can become infected when stool or bacteria become trapped, leading to symptoms such as abdominal pain, fever, and changes in bowel habits.
What is Diverticulitis?
Diverticulitis occurs when the diverticula (small bulging pouches) in the digestive tract, particularly in the colon, become inflamed or infected. It is a serious condition that, if left untreated, can lead to complications like abscesses, perforation, peritonitis, and sepsis.
The condition is typically treated with antibiotics, dietary changes, and in severe cases, surgery.
Nursing Diagnoses for Diverticulitis
- Acute Pain
- Imbalanced Nutrition: Less Than Body Requirements
- Risk for Infection
- Deficient Knowledge
- Risk for Fluid Volume Deficit
Each diagnosis is critical in guiding nursing care and interventions to support patients throughout the course of their treatment for diverticulitis.
1. Nursing Diagnosis: Acute Pain
Related to: Inflammation and infection of the diverticula
As evidenced by: Patient reports of sharp, cramping abdominal pain, typically in the lower left quadrant; facial grimacing; guarding of the abdomen.
Nursing Interventions and Rationale:
- Monitor and assess pain levels frequently: Use a pain scale to help quantify the patient’s pain and evaluate the effectiveness of interventions. This assists in identifying the need for further medical management (e.g., analgesics).
- Administer prescribed analgesics as ordered: Pain relief helps reduce the patient’s discomfort and supports recovery by decreasing stress levels and improving rest.
- Provide a low-fiber diet as recommended during acute phases: A low-fiber diet reduces bowel stimulation, minimizing pain caused by bowel movements or gas formation.
- Educate the patient on non-pharmacological pain relief techniques (e.g., relaxation, heat application): These methods can supplement pain medications and provide comfort.
2. Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements
Related to: Decreased oral intake due to abdominal pain and dietary restrictions
As evidenced by: Weight loss, poor appetite, weakness, and patient-reported difficulty eating.
Nursing Interventions and Rationale:
- Monitor daily weight and nutritional intake: Regularly assessing the patient’s weight helps track nutritional status and ensures that calorie and nutrient needs are being met.
- Collaborate with a dietitian to develop an appropriate meal plan: A dietitian can help create a plan that meets the patient’s nutritional needs while considering the restrictions required for diverticulitis (e.g., low-fiber diet during acute episodes).
- Encourage small, frequent meals: Offering small meals at regular intervals may improve the patient’s tolerance to food and prevent weight loss.
- Administer vitamin and mineral supplements as prescribed: Supplements may be necessary to correct deficiencies caused by decreased intake or malabsorption.
3. Nursing Diagnosis: Risk for Infection
Related to: Inflammation, bacterial invasion, or perforation of diverticula
As evidenced by: Risk factors like the presence of diverticula, abdominal tenderness, and fever.
Nursing Interventions and Rationale:
- Monitor for signs of infection (fever, increased WBC count, chills): Early detection of infection is critical for prompt treatment and to prevent complications like abscess or sepsis.
- Administer antibiotics as prescribed: Timely antibiotic administration helps control the infection and prevent its spread to other parts of the body.
- Maintain strict aseptic technique during procedures: This reduces the likelihood of introducing new pathogens, particularly when handling catheters or wound care after surgery.
- Educate the patient on the importance of completing the full course of antibiotics: Completing antibiotics ensures the infection is fully treated and reduces the risk of resistance.
4. Nursing Diagnosis: Deficient Knowledge
Related to: Lack of exposure to information about diverticulitis, its causes, and management
As evidenced by: Patient questions, anxiety about condition, and misconceptions about the disease process.
Nursing Interventions and Rationale:
- Assess the patient’s understanding of diverticulitis: Identify gaps in knowledge that may affect self-management and recovery.
- Provide education on the pathophysiology of diverticulitis, treatment options, and dietary management: This helps empower patients to take an active role in managing their condition.
- Teach the importance of dietary modifications, including avoiding seeds, nuts, and other foods that can worsen symptoms: This knowledge can reduce the recurrence of diverticulitis and improve overall outcomes.
- Provide written materials or videos to reinforce education: Written materials provide the patient with resources to reference after discharge, ensuring understanding and adherence to recommendations.
5. Nursing Diagnosis: Risk for Fluid Volume Deficit
Related to: Vomiting, diarrhea, fever, and decreased oral intake
As evidenced by: Risk factors like fever, diarrhea, or refusal to eat/drink.
Nursing Interventions and Rationale:
- Monitor fluid intake and output closely: This helps in detecting early signs of dehydration, such as decreased urine output or dry mucous membranes.
- Encourage oral fluid intake, if tolerated: Oral hydration is the preferred method for maintaining fluid balance unless contraindicated by the patient’s condition.
- Administer IV fluids as prescribed: Intravenous fluids may be necessary to correct dehydration and maintain electrolyte balance in patients unable to tolerate oral intake.
- Monitor vital signs and lab values (electrolytes, BUN, creatinine): These indicators help assess the patient’s fluid balance and the effectiveness of interventions.
References:
- Sawyer, R. G., Claridge, J. A., Nathens, A. B., Rotstein, O. D., Duane, T. M., Evans, H. L., & Lee, J. M. (2022). Management of complicated diverticulitis. Journal of Trauma and Acute Care Surgery, 92(4), 946-957. Link
- Strate, L. L., & Morris, A. M. (2020). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 156(5), 1282-1291. Link
- Peery, A. F., & Crockett, S. D. (2019). Diverticular disease: Epidemiology and management. BMJ, 367, l6700. Link
- Wilkins, T., Embry, K., & George, R. (2021). Diagnosis and management of diverticulitis. American Family Physician, 100(4), 219-225. Link
- Hall, J., & Roberts, P. L. (2021). Diverticular disease: Current concepts and clinical practice. Annals of Surgery, 273(4), 595-604. Link