Acute Diverticulitis Essay

diverticulitis. The patient has no diet regimen, which may be the likely cause of his

Abdomen: The lipases appeared unremarkable. The liver, spleen, gallbladder adrenals, kidneys, pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seemed consistent with acute appendicitis. All the structures of the abdomen appeared unremarkable. No free air was seen.

I am a second year nursing student in my third week of the practicum placement on a surgical ward with my co-student and the morning shift registered nurses. We had just finished analysing the patients handover report (Levett-Jones & Bourgeois, 2015) and I had been assigned to work with the registered nurse. I was looking after Mrs. Brown (pseudonym) is 82 years old New Zealander was admitted to surgical ward on the 08/06/16 for multiple SCC removals from L) hand and L) foot with skin grafts.

B.S. is an 81 year old Caucasian female presenting with abdominal pain, diarrhea, nausea and vomiting in the emergency room on February 3, 2013. B.S. has a history of glaucoma, hypothyroidism, degenerative arthritis and diverticulosis. She has allergies to iodine and vicodin. B.S. is admitted for diverticulitis with possible partial bowel obstruction and hydronephrosis. B.S. was admitted on February 3, 2013 here at Verdugo Hills Hospital.

I was looking forward to this clinical as I was getting used to the environment. I worked with two patients. One of my patient was a 70-year-old male who came in with vomiting and diarrhea. They wanted to put him on C diff precaution, but they isolated him, as they are still growing stool cultures. What I have learned during this clinical was to check the last vital signs and accucheck first thing in the morning. This would help me prioritize my task for the patient. I went into the patient’s room and I did an assessment him. I had a positive interaction with the patient. He says he was improving ever since his admission. The nurse came in and stated that the doctors switched his diet to clear liquid. Therefore, I gave him jello and apple juice from the fridge. He had a bowel movement later, which was diarrhea. Then, I was concerned about his fluid and electrolytes. Therefore, I let the nurse know that he had a bowel movement that was watery. He also had lactate ringers IV attached to him. Therefore, when he was trying to go to the bathroom, I had to make sure he does not trip because of it. The doctor came later to check on the patient, and told him that he will soon be discharged. Nevertheless, they are still growing stool cultures because it takes a few days for it to

BIOLOGICAL MECHANISM: The condition of diverticulosis occurs when small areas of tissue form pouches in the large intestine or colon called diverticulum, or diverticula (plural). Diverticula may occur due to the lack of bulk forming and bacteria producing fiber, resulting in an imbalance of certain intestinal bacteria, increasing internal pressure on the intestinal tissue due to poor stool formation, constipation, or straining to pass stools. In the paper Low-Residue Diet in Diverticular Disease: Putting an End to a Myth it was stated that “fiber is an important energy substrate for the colonic epithelium because of its fermentation by colonic microbes to short-chain fatty acids, which in turn play a role in mucosal growth and colonic blood flow” (Tarleton, DiBaise 2011). Poor tissue health and increased internal pressure may cause the intestinal tissue to herniate causing diverticulum to form. Diverticulitis can occur when material or bacteria becoming trapped inside the diverticulum, and inflammation

D.D is a 16 yr old male who was in his usually state of health until he developed right-sided abdominal pain approximately 5 days prior to arriving at the hospital. His pain progressively worsened and spread throughout his abdomen. He also had nausea non-bloody, non-bilious vomiting, some diarrhea, as well as fevers, when pain did not improve he presented to ER. He was admitted and diagnosed with sepsis and perforated appendicitis. He had a laparoscopic appendectomy and a central venous catheter was placed. Following surgery he was then transferred to the med-surg floor. His parents are both Spanish speaking and at the bedside.

During my Med-Surg clinical, I was assigned to a patient who was a 94 year female that had several medical conditions. The situation that ensued was difficulty communicating with her, since she did not speak English. Not only did the patient not speak English, but was only alert to herself, as well as extremely confused. As a result, being able to provide effective and quality care became a challenge. The reason for her admission was hyperkalemia, UTI, congestive heart failure (CHF) and acute renal failure (ARF). Unfortunately, the patient had other comorbidities that affected her well being such as diabetes mellitus, hypertension, atrial fibrillation, BPPV, CAD, s/p stent, DVT, CKD, stage 4 sacral decubitus ulcer, cholecystectomy, hip fracture and LE fasciotomy DVT.

Thus allowing me to form a differential diagnosis and rule out certain causes, such as; constipation, and indigestion. Subsequently, the physical examination enabled me to confirm a diagnosis of acute abdomen. As the patient was not experiencing any worrying (red flag) symptoms associated with abdominal emergencies, such as; appendicitis or pancreatitis. However, I did forget certain aspects of the physical examination and had to be prompted by the MO. Although with more practice such incidence would be reduced.

Health care providers use the Rome Criteria, which is a group of the most common symptoms that characterize IBS. The Rome Criteria includes abdominal discomfort during the span of several months or longer that is associated with at least two of the following: “the pain or discomfort is relieved by defecation, the pain or discomfort is associated with an increase or decrease in stool frequency, and/or the pain or discomfort is associated with the stools becoming harder or softer in consistency” (International). After the Rome Criteria is concluded, the provider must look for signs and symptoms that are suggestive of a condition other than IBS, such as inflammatory bowel disease or celiac disease. These signs and symptoms have been referred to as “red flags”, which include: rectal bleeding, iron-deficiency anemia (IDA), weight loss, family history of colon cancer, fever, and age of onset after age

DS is a 57-year-old white female whit a history of diverticulitis who presents to the clinic for an evaluation of abdominal pain. She stated that she began experiencing left lower quadrant pain last night that worsened through the night and into this morning. The pain is described as dull, occasionally cramping, rated 7/10 in severity. The patient also stated that this pain is similar to previous episodes of diverticulitis. The patient stated that she took Gas-X this morning with little relief. She was able to move her bowels yesterday and this morning, both reportedly normal. The patient denied any fever, chills, chest pain, shortness of breath, nausea, vomiting, diarrhea, melena, hematochezia, or any other symptoms. At this time, there were

The intestines consist of a long, flexible tube that is coiled around, so it appears to be smaller than it actually is. In a healthy person, it is smooth inside and out, so waste can move through it easily since the large intestines are the last stop before waste passes on its way out of the body. But as a person ages, there are pouches that begin to form in the large intestines. This condition is called diverticulosis. The bulges make passing waste more difficult, so sometimes, it gets caught in them or irritates them. When the pouches become inflamed and infected, it is referred to as diverticulitis. This condition can be very painful. It causes constipation, abdominal pain, a low grade fever, and nausea. The symptoms can last for just a few days or for several weeks. And once someone gets the condition, it is often something that they struggle with on and off for years if they don't treat it properly.

However, both conditions—Ulcerative colitis and Crohn’s disease can be diagnosed by performing the following: health history, physical and mental assessment in combination with several diagnostic investigations. Throughout these assessments, gathered is patient clinical history such as lifestyle, prescription drugs, recreational drugs, diet, smoking status, bowel movements, and appearance of the faeces, family history, vomiting; and nausea. Diagnostic procedures and test are: endoscopy, colonoscopy, barium enema, CT scan, MRI. In addition, biochemistry tests are performed such as: faecal sample examination, full blood count, iron studies, inflammatory markers and special antibodies test. Computer tomography in procedure used to diagnose diverticulitis, during an acute episode, barium enema, endoscopy or colonoscopy to diagnose diverticulosis. (Digestive Health Foundation, 2013).

Changes in the abdominal exam help doctors tell if appendicitis is progressing, as well.” this is cited from-http://www.webmd.com/digestive-disorders/picture-of-the-appendix. For unclear reasons, the appendix often becomes inflamed, infected, and can rupture. This causes severe pain in the right lower part of the belly, along with nausea and vomiting.Tumors of the appendix: Carcinoid tumors secrete chemicals that cause periodic flushing, wheezing, and diarrhea. Epithelial tumors are growths in the appendix that can be benign or cancerous. Appendix tumors are rare. This comes

The patient was pleasant and cooperative even though she was in pain. The patient was sent to the hospital because of the severe pain and quick confirmation of the diagnosis using Cat Scan. I encouraged her to return to the clinic after her discharge. I informed the patient that if her diagnosis is diverticulitis then, she could possibly reduce the flare up by increasing her fiber intake. We also discussed her weight and agree to work on that the next time that she comes. When I brought up her smoking habit, she informed that she will quit but not this year. I still went ahead to remind her about the consequences of smoking. Overall it was very pleasant encounter. All the subjective and objective finding on this patient