Diverticulitis

Question 1

What are diverticulosis and diverticulitis?

Answer 1

Diverticulosis is the formation of hollow sac cavities throughout the intestinal wall, while diverticulitis is a complication of diverticulosis characterized by inflammation of the diverticulum.

Diverticulitis can occur only if diverticulosis is present.

Question 2

Where are diverticula most commonly found?

Answer 2

In the sigmoid colon of the large intestine.

Diverticula are the outpouching sacs formed in the intestinal wall.

Question 3

What is a single diverticulum called?

Answer 3

Diverticulum.

Multiple outpouching areas are referred to as diverticula.

Question 4

What are common signs and symptoms of diverticulosis?

Answer 4

Patients are usually asymptomatic but may experience:
* Change in bowel pattern (sudden constipation/diarrhea)
* Abdominal bloating.

Patients may misattribute these symptoms to other causes.

Question 5

How is diverticulosis often discovered?

Answer 5

Patients may find out they have diverticulosis during a lower GI series for another reason or after experiencing a complication.

Complications may include diverticulitis or diverticular bleeding.

Question 6

What can lead to diverticular bleeding?

Answer 6

Weakening of the artery walls surrounding the diverticulum, leading to GI bleeding or rupture.

This often results in painless bleeding and bright blood in the stool or rectum.

Question 7

What is diverticulitis?

Answer 7

Inflammation of the diverticulum, which can lead to abscess, rupture, peritonitis, and sepsis.

It is a more severe condition resulting from diverticulosis.

Question 8

What are potential complications of diverticulitis?

Answer 8

• Abscess formation
• Rupture of diverticulum
• Bowel obstruction
• Fistula formation.

Abscesses can lead to fever, high WBC count, and intense abdominal pain.

Question 9

What are the causes of diverticulosis?

Answer 9

Not fully understood, but possibly due to:
* Increased pressure in the colon from constipation/straining
* Low fiber diet leading to smaller, drier stools.

Diverticulosis increases with age and may run in families.

Question 10

What may lead to the development of diverticulitis?

Answer 10

Stool getting stuck in herniated pouches or increased pressure causing a tear in the diverticulum.

Infection can occur when bacteria migrate into the out-pouching.

Question 11

What are the signs and symptoms of diverticulitis?

Answer 11

Remember: “Pouch”
* Pain in the abdomen (mainly left lower quadrant)
* Abdominal bloating
* Blood in stool
* Unrelenting cramping pain
* Constipation
* High temperature.

These symptoms indicate inflammation and possible complications.

Question 12

What diagnostic methods are used for diverticulitis?

Answer 12

• Colonoscopy
• CT scan of the abdomen with contrast.

These tests help visualize the extent of the disease.

Question 13

What is the first-line treatment for diverticulitis?

Answer 13

Most cases are treated with IV or oral antibiotics and bowel rest.

Gradual reintroduction of foods occurs as symptoms decrease.

Question 14

What nursing interventions are important for a patient with diverticulitis?

Answer 14

• Monitor GI system and diet status
• Administer medications
• Monitor vital signs
• Observe for signs of peritonitis
• Administer pain medication.

Close monitoring is essential during the initial phase of treatment.

Question 15

What dietary recommendations are made during recovery from diverticulitis?

Answer 15

Initially clear liquids, then low-fiber foods, followed by high-fiber foods once recovered.

Low-fiber foods allow the bowel to rest before transitioning back to high-fiber diets.

Question 16

What is Psyllium (Metamucil) used for?

Answer 16

To help avoid constipation by absorbing water in the intestine, making stool easier to pass.

It is often prescribed to patients with diverticulosis.

Question 17

Should patients with diverticulosis avoid seeds and nuts?

Answer 17

No, recent research shows they do not have to avoid seeds and nuts unless intolerant.

This contrasts with previous beliefs regarding dietary restrictions.

Question 18

Most patients with diverticulosis are most likely to have diverticula located in the?

A. Transverse colon
B. Sigmoid Colon
C. Rectum
D. Ascending Colon

Answer 18

B: sigmoid colon

Diverticulosis can occur throughout the GI tract but is most common in the sigmoid colon.

Question 19

Which statement demonstrates understanding of diverticulitis versus diverticulosis?

A. “Most patients with diverticulitis are asymptomatic.”
B. “Diverticulosis tends to occur in young women with a family history of diverticulosis.”
C. “Diverticulitis, if not treated, can lead to abscess formation and peritonitis.”
D. “Patients with diverticulosis should at all times avoid eating seeds and nuts.”

Answer 19

C: ‘Diverticulitis, if not treated, can lead to abscess formation and peritonitis.’

Option A is incorrect because patients with diverticulosis are usually asymptomatic, while those with diverticulitis have symptoms.

Question 20

Which findings correlate with diverticulitis? SELECT-ALL-THAT-APPLY:

A. Abdominal pain that is mainly present in the upper right quadrant
B. Unrelenting cramping type pain
C. Pain found at McBurney’s Point
D. Blood in stool
E. Fever
F. Reports of constipation
G. Abdominal bloating
H. Positive Cullen’s Sign

Answer 20

B, D, E, F, G

Typical signs and symptoms include unrelenting cramping pain, blood in stool, fever, reports of constipation, and abdominal bloating.

Question 21

What type of testing is performed to assess for diverticulosis?

A. Colonoscopy
B. Fleets enema
C. Bronchoscopy
D. Cystoscopy

Answer 21

A: Colonoscopy

This is the only option that can assess for diverticulosis.

Question 22

In a patient experiencing an acute episode of diverticulitis, what is important to monitor?

A. Encourage intake of high-fiber foods
B. Monitor the patient for peritonitis
C. Apply a heating pad to the patient’s abdomen to help alleviate pain
D. Encourage intake of full liquids

Answer 22

B: Monitor the patient for peritonitis

The patient is at risk for abscess leading to peritonitis if the abscess ruptures.

Question 23

Which food items are best for a patient recovering from diverticulitis?

A. Oatmeal and bran
B. Orange juice and eggs
C. Chicken broth and Jello
D. Salad with chicken

Answer 23

C: Chicken broth and Jello

Clear liquids should be consumed during the recovery phase, followed by low-fiber foods until healed.

Question 24

Which statement by a patient requires re-education regarding diverticulitis?

A. “It is important I consume a diet high in fiber and keep hydrated to keep my stool soft.”
B. “The physician prescribed me to take Psyllium every day which will help prevent constipation.”
C. “I will be sure to always cook and skin my fruits and vegetables rather than eating them fresh.”
D. “I will notify my physician if I develop abdominal pain and fever.”

Answer 24

C: ‘I will be sure to always cook and skin my fruits and vegetables rather than eating them fresh.’

Fresh fruits and vegetables are important for a high-fiber diet.

Question 25

True or False: Most patients with chronic diverticulitis require surgery at some point. True False

Answer 25

False ## Footnote Most patients might require surgery, and if the healthy bowel cannot be reconnected right away, a temporary colostomy will be created.