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Okay, diverticulitis and diverticulosis. The reason I put these two together is because one is simply an exacerbation of the other. This is truly a pretty simple condition, but let’s talk about it really quick and let’s talk about what’s going on here.
So, diverticulosis. What is diverticulosis? Here is an image of a large intestine. What we’ll see here, here’s normal mucosa. These out pouching’s, down here, are the diverticuli. Diverticulosis is simply out pouching of the intestinal mucosa. You can, kind of, see the difference between the out pouching’s and the normal ones. What happens with diverticulosis is these out pouching’s develop and they just happen along the intestinal mucosa.
This is not a big deal. It’s not a huge ordeal. The problem is, however, if something gets trapped inside here, a little seed, little pieces of food, et cetera, get trapped inside these diverticuli and then they start to become inflamed. As they become inflamed, they can become infected. This infection, this bacteria, can lead to perforation and peritonitis. So, once the diverticuli become inflamed, that becomes diverticulitis and these diverticulitis can lead to perforation and peritonitis. So, that’s where the concern is with this.
Again, we have our large intestine here, and along our large intestine, right … We know this is all, kind of, bumpy and everything. Along our large intestine what can happen is we can develop these little diverticuli. Not a huge deal. That can be assessed via colonoscopy. We bring a little camera appear and we check it out. Okay, looks good, looks good.
What can happen, however, with these diverticuli is they can become inflamed and infected and that can lead to peritonitis. That can become a much bigger ordeal. This, here, is diverticulosis. This inflamed one, here, is diverticulitis. You can use your medical terminology course you took here, -itis is going to be an inflammation. Diverticulitis is an inflammation of a diverticuli.
What’s our assessment going to be like? Again, here’s our colon here. What you’ll see here, you can see these little diverticuli. Okay, these little out pouching’s within the mucosa. What we’ll see is, we’ll see left lower quadrant pain worsening with straining. So, as the patient is trying to strain, possibly coughing, or going to the bathroom, then you’re going to see that that left lower quadrant pain gets worse. This is all with diverticulitis. They might have an increased temp. That might be a sign of inflammation and infection. They may have nausea and vomiting. They may have abdominal distention, just kind of like a bloated abdomen, a bloated feeling. They may have melena. Melena is blood in the stool. It’s going to be really stinky. It’s going to be really dark and it may be red. Okay. That would be melena.
Therapeutic management for these patients is going to be NPO, to provide bowel rest. We’re going to have them go to bed rest and we are going to introduce fiber slowly. We also want to increase fluid intake to help soften the stool and allow it to pass, avoid gas forming foods and provide bulk forming laxatives. A big thing you’re going to see, this is going to be a key to [inaudible 00:04:22] here. You want to have them avoid nuts and foods with small seeds, nuts, things like strawberries, any foods with small seeds, popcorn, any foods that have small seeds that can become trapped inside those diverticuli and lead to the information. We can also have colectomy, which could be a removal of a portion of the colon, or we can have colostomy.
So, let’s talk about colostomy really quick or colectomy. If a person has a colostomy, a colectomy, they’re going to end up with a colostomy, okay, right? What happens here … let’s say, here’s our colon again …