Case Study: solved an 84 year
old female who has a history of
diverticular disease course hero
An 84- year-old -female who has a history
of diverticular disease presents to the clinic
with left lower quadrant (LLQ) pain
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An 84-year-old-female who has a history of diverticular disease...
An 84- year-old -female who has a history of diverticular disease presents to the clinic with left lower quadrant (LLQ) pain of the abdomen
that is accompanied by with constipation, nausea, vomiting and a low-grade fever (100.20 F) for 1 day.
On physical exam the patient appears unwell. She has signs of dehydration (pale mucosa, poor skin turgor with mild hypotension [90/60
mm Hg] and tachycardia [101 bpm]). The remainder of her exam is normal except for her abdomen where the NP notes a distended, round
contour. Bowel sounds a faint and very hypoactive. She is tender to light palpation of the LLQ but without rebound tenderness. There is
hyper-resonance of her abdomen to percussion.
, The following diagnostics reveal:
Stool for occult blood is positive.
Flat plate abdominal x-ray demonstrates a bowel-gas pattern consistent with an ileus.
Abdominal CT scan with contrast shows no evidence of a mass or abscess. Small bowel in distended.
Based on the clinical presentation, physical exam and diagnostic flndings, the patient is diagnosed with acute diverticulitis and she is
admitted to the hospital. She is prescribed intravenous antibiotics and fluids (IVF). Her symptoms improved and she could tolerate a regular
diet before she was discharged to home.
Discussion Questions:
1. Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
2. Identify the clinical flndings from the case that supports a diagnosis of acute diverticulitis.
3. List 3 risk factors for acute diverticulitis.
4. Discuss why antibiotics and IV fluids are indicated in this case.
Health Science Science Nursing NURSING NR 507 섈 쉋
Comments (1) 쇱
Answer & Explanation Solved by verified expert 숨
1. Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
2. Identify the clinical flndings from the case that supports a diagnosis of acute diverticulitis.
3. List 3 risk factors for acute diverticulitis.
4. Discuss why antibiotics and IV fluids are indicated in this case.
Please see the explanation below.
Step-by-step explanation
Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
Diverticulosis is the formation of abnormal pouches in the bowel wall. Diverticulitis is inflammation or infection of these
abnormal pouches. These conditions are known as diverticular disease. Treatment options include a change of diet, antibiotics
and surgery. The pathophysiology between diverticular disease or diverticulosis and diverticulitis, the development of
diverticula in the colon typically occurs in parallel rows between the taenia coli. The pathogenesis of the disorder involves
three major areas structural abnormalities of the colonic wall, disordered intestinal motility, and deflciencies of dietary flber.
Additional factors have also been linked to diverticular disease. Diverticulosis is characterized by the presence of sac-like
protrusions or diverticula that form when colonic mucosa and submucosa herniated through defects in the muscle layer of the
colon wall.
Diverticulitis is the result of microscopic and macroscopic perforations of the diverticular wall. Practitioners thought
that obstruction of colonic diverticulum with fecaliths led to increased pressure within the diverticulum and subsequent
perforation. They now theorized that increased luminal pressure is due to food particles that lead to erosion of the diverticular
wall. This causes focal inflammation and necrosis of the region, causing perforation. Surrounding mesenteric fat may easily
contain micro-perforations. This can result in local abscess formation, flstulization of adjacent organs, or intestinal obstruction.
old female who has a history of
diverticular disease course hero
An 84- year-old -female who has a history
of diverticular disease presents to the clinic
with left lower quadrant (LLQ) pain
Question Find study &
Answer resources
Explanation Related Questions Related Courses 숿
Question Ⓒ Answered step-by-step
An 84-year-old-female who has a history of diverticular disease...
An 84- year-old -female who has a history of diverticular disease presents to the clinic with left lower quadrant (LLQ) pain of the abdomen
that is accompanied by with constipation, nausea, vomiting and a low-grade fever (100.20 F) for 1 day.
On physical exam the patient appears unwell. She has signs of dehydration (pale mucosa, poor skin turgor with mild hypotension [90/60
mm Hg] and tachycardia [101 bpm]). The remainder of her exam is normal except for her abdomen where the NP notes a distended, round
contour. Bowel sounds a faint and very hypoactive. She is tender to light palpation of the LLQ but without rebound tenderness. There is
hyper-resonance of her abdomen to percussion.
, The following diagnostics reveal:
Stool for occult blood is positive.
Flat plate abdominal x-ray demonstrates a bowel-gas pattern consistent with an ileus.
Abdominal CT scan with contrast shows no evidence of a mass or abscess. Small bowel in distended.
Based on the clinical presentation, physical exam and diagnostic flndings, the patient is diagnosed with acute diverticulitis and she is
admitted to the hospital. She is prescribed intravenous antibiotics and fluids (IVF). Her symptoms improved and she could tolerate a regular
diet before she was discharged to home.
Discussion Questions:
1. Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
2. Identify the clinical flndings from the case that supports a diagnosis of acute diverticulitis.
3. List 3 risk factors for acute diverticulitis.
4. Discuss why antibiotics and IV fluids are indicated in this case.
Health Science Science Nursing NURSING NR 507 섈 쉋
Comments (1) 쇱
Answer & Explanation Solved by verified expert 숨
1. Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
2. Identify the clinical flndings from the case that supports a diagnosis of acute diverticulitis.
3. List 3 risk factors for acute diverticulitis.
4. Discuss why antibiotics and IV fluids are indicated in this case.
Please see the explanation below.
Step-by-step explanation
Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
Diverticulosis is the formation of abnormal pouches in the bowel wall. Diverticulitis is inflammation or infection of these
abnormal pouches. These conditions are known as diverticular disease. Treatment options include a change of diet, antibiotics
and surgery. The pathophysiology between diverticular disease or diverticulosis and diverticulitis, the development of
diverticula in the colon typically occurs in parallel rows between the taenia coli. The pathogenesis of the disorder involves
three major areas structural abnormalities of the colonic wall, disordered intestinal motility, and deflciencies of dietary flber.
Additional factors have also been linked to diverticular disease. Diverticulosis is characterized by the presence of sac-like
protrusions or diverticula that form when colonic mucosa and submucosa herniated through defects in the muscle layer of the
colon wall.
Diverticulitis is the result of microscopic and macroscopic perforations of the diverticular wall. Practitioners thought
that obstruction of colonic diverticulum with fecaliths led to increased pressure within the diverticulum and subsequent
perforation. They now theorized that increased luminal pressure is due to food particles that lead to erosion of the diverticular
wall. This causes focal inflammation and necrosis of the region, causing perforation. Surrounding mesenteric fat may easily
contain micro-perforations. This can result in local abscess formation, flstulization of adjacent organs, or intestinal obstruction.
