Pathophysiology of acute and chronic diverticulitis, Other Subject

Mrs. Dolan, 46 year-old female presented to the ED with complaints of episodic abdominal pain, a low grade fever, and diarrhea for about two weeks. She was in another country, on vacation, when she developed pain in her left lower quadrant of her abdomen. Mrs. Dolan did not seek healthcare because of fear of the country's unfamiliar medical system and the assumption that the bad water or food she had while on vacation must have given her a stomach "bug". She also complains of painful urination.

Upon examination, she is found to be dehydrated with a fever of 102.5°F. VS: BP106/58, pulse 88, respiratory rate 22. Height is 67 inches and weight is 77.3 kg. Labs: K+2.8 mEq/L, ESR 37mm/hr, WBC 16,000 cells/mm³. Urinalysis showed a positive urinary tract infection and a CT of the abdomen and pelvis showed diverticulitis and possible ileus.

Mrs. Dolan is admitted, started on D5 ½ NS with 20mEq KCL at 50mL/hr. Cefoxitin sodium and metronidazole are prescribed. Admission orders include: NPO, bedrest, morphine sulfate as needed for pain management, check stools for occult blood, strict I&O, repeat labs in AM to monitor K+. She is also prescribed diphenoxylate hydrochloride with atropine sulfate, propantheline bromide, and acetaminophen, PRN.

1. Summarize the Pathophysiology of acute and chronic diverticulitis.

2. Identify any contributing factors for the development of diverticulitis in this case.

3. How might these symptoms be related to her urinary tract infection?

4. What diagnostic tests are used to determine diverticulitis?

5. Discuss all routine and PRN medications and indication for use in this case.

6. List three nursing diagnoses, with 2 interventions each, for this patient.

Posted Date: 2/15/2013 12:16:02 AM | Location : United States







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