Sigmoid diverticulitis occurs when pouches form in the sigmoid colon wall and become inflamed. Symptoms include abdominal pain, fever, nausea, and bleeding. Diagnostic tests include CT scans, barium enemas, and colonoscopies. Treatment involves antibiotics, fluids, pain medication, and sometimes surgery to remove the inflamed portion of the colon. For patients undergoing laparoscopic sigmoid colon resection, the procedure removes the diseased part of the colon and reattaches the healthy parts. Post-operative care focuses on pain management, monitoring the surgical site, and early ambulation.
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clinical prep diverticulitis
1. Name:Amanda Meyers Patient Initials: H.T. Date: 11/10/2011
CLINICAL PREPARATION WORKSHEET
Medical Diagnosis:Sigmoid Diverticulitis
1. Pathophysiology of Medical Condition: (define and describe in your own words -- cite
reference in APA format)
Diverticulitis can occur in the small or large intestine but most often in the sigmoid colon. Point of
weakness in the wall of the intestine is where diverticula normally occur. The aging process as well as
lack of fiber in the diet can lead to weakness of the colon muscles. The colon muscle becomes thick and
rigid and hermiation of the mucosa and submucosa can be seen through the colon wall. It is found in one
half of adults over the age of 60.
(Ignatavicius & Workman, 2010, p. 1334)
2. Clinical Manifestations: (those that a patient with this diagnosis may manifest – cite
reference)
Symptoms (Subjective) Signs (Objective)
Abdominal pain Bleeding from colon
Chills Constipation
Low grade fever
Nausea/vomiting
Abdominal distention
Acute confusion in older adults
(Ignatavicius & Workman, 2010, p. 1334)
3. Diagnostic Tests/Labs: (those pertaining to any patient with this diagnosis – cite reference)
X-rays with barium contrast
Colonoscopy
CT scan
Stool test = occult blood
Urinalysis= RBC’s
(Ignatavicius & Workman, 2010, p.1335)
4. Medical/Surgical Treatments/Medications/Therapies: (for any patient with this diagnosis –
cite reference)
Nonsurgical =combination of drug and nutrition therapy and rest to decrease inflammation
Broad spectrum antimicrobial drugs
Mild analgesic for pain
IV fluids
Anticholinergics=reduce intestinal hypermotility, should be avoided for older adults
Surgical = colon resection
(Ignatavicius & Workman, 2010, p. 1336)
5. Nursing care directed toward signs/symptoms: (for any patient with this diagnosis – cite
reference)
Teach pt. to rest during acute phase
Teach pt. not to lift, strain, coughing or bending to avoid increase in intra-abdominal pressure
Teach pt. about nutrition = diet low in fiber and clear liquids
Educate pt. about avoiding laxatives
Assess pt. for fluid and electrolyte imbalance
Teach pt. incision care and colostomy care with limited activities
Educate pt.that alcohol should be avoided
Encourage pt. to express concerns about body image with a colostomy
(Ignatavicius & Workman, 2010, p. 1336)
2. Name:Amanda Meyers Patient Initials: H.T. Date: 11/10/2011
CLINICAL PREPARATION WORKSHEET
Surgical Procedure: Laparascopic Sigmoid Colon Resection
1. Briefly describe the purpose of the surgical procedure during this hospital
stay: (define and describe in your own words – cite reference in APA format).
A laparascopic sigmoid colon resection is a procedure that removes the part of the
colon that is inflamed or diseased and an anastomosis is created if possible to restore
the patency of the colon.
(Ignatavicius & Workman, 2010, p. 1336)
2. Post-operative Treatments/Medications/Therapies: (cite reference)
Colostomy with a stoma
Analgesics for pain
(Ignatavicius & Workman, 2010, p. 1336)
3. Nursing Care directed toward post-operative patient needs: (cite reference)
Assess vital signs every 15 minutes for 4 times then every 30 for 4 times and then every
2 hours
Assess surgical area for bleeding and drainage
Turn pt. every 2 hours
Assess pt. for pain
Assist pt. with ambulation
(Ignatavicius & Workman, 2010, p. 1336)