Week 5 Diverticular Disease, Hernia, Hemorrhoids

Question 1

what are the symptoms of diverticulosis?

Answer 1

Pt is asymptomatic.
Except may have crampy pain, constipation or diarrhea

Question 2

What is diverticulitis?

Answer 2

Inflammation of the diverticula due retention of stool in the outpouchings.

Forms a fecalith (hard mass).

Inflammation spreads to surrounding tissues.

Question 3

What are 6 complications that may occur with diverticulitis?

Answer 3

1.Perforation with peritonitis
2.Abscess
3.Fistula formation
4.Bowel obstruction
5.Ureteral obstruction
6. Bleeding- usually resolves

Question 4

what are symptoms of diverticulitis?

Answer 4

1.Abdominal pain over involved area
2.Tender lower left quadrant mass
3. S&S of infection (Fever chills, nausea, anorexia, elevated WBCs)

Question 5

Where does diverticulitis often manifest?

Answer 5

sigmoid colon
lower left quadrent

Question 6

How do we treat diverticulitis?

Answer 6

1.Monitor for infection
2.Rest the bowel -NPO with IV fluid
3.low fiber diets for mild flare ups
4.IV Fluids and A/B for severe symptoms
5.Surgery- if needed to get rid of a mass

Question 7

What are the 4 types of hernia?

Answer 7

1. Inguinal,
2. Femoral,
3. Umbilical,
4. Incisional

Question 8

What are the signs & symptoms of hernia?

Answer 8

1. Pain to area of hernia
2. can patient push it back in?
3. Is there strangulation? can have S&S of bowel obstruction.
   -Is a Surgical Emergency!!!

Question 9

What sign indicates an emergency in someone with a hernia?

Answer 9

Bowel obstruction signs b/c that indicates strangulation

Question 10

What are 3 interventions for hernia?

Answer 10

1.Watchful waiting
May wear truss.

2.Herniorrhaphy
Surgical repair of a hernia.

3. Hernioplasty
   Surgical reinforcement of the weakened area with a fascia or mesh.

Question 11

What are some special post-op considerations for hernia DIFFERENT than regular post-op care?

Answer 11

1. observe for bladder distension
2. Scrotal support may help relieve discomfort.
3. Coughing is not encouraged- but deep breathing and turning should be done.
4. Splint the incision.
5. Position appropriately (decrease pressure in suture line).

Question 12

What are hemorrhoids and what are they cause by?

Answer 12

Varicosities in the lower rectum or the anus caused by congestion in the veins

Portal hypertension - liver disease
straining
constipation
pregnancy
heavy lifting
prolonged standing/sitting

Question 13

What are the treatment options for hemorrhoids?

Answer 13

1.High fibre diet
2.Increased fluid intake
3.Surgical excision
4.Band ligation
5.Cryotherapy (rapid freezing), Laser treatment
6. Hemorrhoidectomy

Question 14

what is helpful for people post hemorrhoidectomy and why?

Answer 14

• very painful*
  -Narcotics for Sphincter Spasm
  -Sitz Bath 1-2 days post surgery
  -Dressing change/packing
  -Stool Softeners (Colace)
  -Analgesics before bowel movement