Diverticulosis is a disease of the colon in which pouches form on the colon walls. Diverticula are formed when pockets of intestinal material bulge through weak spots in the wall. These pockets can become inflamed or infected, causing symptoms such as pain, cramping and fever. A diagnosis of diverticulitis is made when these symptoms persist for at least two days and cause signs of inflammation in the abdomen, such as tenderness or swelling. The main objective for caring for patients with diverticulitis is to prevent complications. Therefore, nursing interventions should focus on preventing other disease states associated with digestive tract disorders such as colorectal cancer and inflammatory bowel disease (IBD).
Diverticulitis Nursing Diagnosis
1 Acute pain related to inflammation, perforation, and/or abscess
The most common symptom of diverticulitis is pain, typically in the left lower quadrant. The pain can be described as sharp or cramping. It may be accompanied by nausea, vomiting, and/or fever. The pain can be intermittent or constant.
2 Constipation related to opioid analgesia
It is important to understand how opioids cause constipation. Opioids act upon the mu receptors in the gut, resulting in a diminished ability to move food through the digestive tract and decreased secretion of fluid from the small intestine. These effects can result in slowed movement of stools through the colon, resulting in constipation. Constipation can also occur as a side effect of other medications or as a result of inadequate fluid intake, dehydration from hot weather or exercise, or changes that occur with aging (elderly people may be less able to retain water).
Relief from opioid-induced constipation is achieved by increasing fluid intake and dieting high fiber foods such as fruit and vegetables; laxative drugs are not typically necessary unless medication regimen does not improve symptoms within 48 hours.
3 Impaired physical mobility related to pain
Pain, whether acute or chronic, can cause immobility. Pain is a subjective phenomenon that may be difficult to measure but it is often associated with depression, anxiety, nausea and other conditions that interfere with an individual’s ability to participate in normal activities of daily living (ADL). This impairs physical mobility and therefore contributes to poor outcomes such as weight loss, fatigue and weakness.
4 Ineffective health maintenance related to lack of knowledge of diverticulosis
- You lack knowledge of diverticulosis.
- Diverticulosis is a common condition, but it’s not serious or life-threatening.
- You may have heard that you need to be screened for diverticulosis, but this isn’t true.
- If you have a family history of the disease, your doctor might suggest screening tests on occasion (for example, at ages 40 and 50). But otherwise, there is no reason to get tested for diverticulosis unless you have symptoms of the disease or other conditions related to it (see below).
- Even if you are experiencing symptoms like abdominal pain and diarrhea—which could be caused by diverticulitis—these aren’t signs that your condition has progressed significantly enough to require treatment or monitoring by healthcare providers in most cases.*
5 Readiness for enhanced family coping/relationships
- Readiness for enhanced family coping/relationships. Family members need to be educated about the disease and its treatment, as well as the patient’s condition, symptoms, and prognosis.
- They need to be involved in their loved one’s care.
- They should be able to express their feelings and concerns; this is especially true if they are feeling helpless or hopeless.
- They should be able to cope with the disease (or death).
6 A nursing diagnosis can help prevent other complications.
A nursing diagnosis can help prevent other complications. While it’s common to have a single diagnosis, you may see that some patients have multiple diagnoses. In this case, they are related and are considered part of the same problem. For example, if someone has diverticulitis, they may also be diagnosed with constipation or diarrhea by their physician. By identifying these related issues at once and working as a team between your physician and yourself (the registered nurse), you can prevent future occurrences of complications from taking place in your patient’s care.
The nursing diagnoses in this chapter are intended to provide an overview of common problems that patients with diverticulitis may experience. The goal of treatment is to alleviate symptoms, prevent complications, and encourage self-care. By working as a team with your patient, you can help them overcome these challenges and live a happier and healthier life.