Diverticulitis is a serious gastrointestinal condition that requires careful nursing assessment and intervention. This comprehensive guide covers essential nursing diagnoses, interventions, and care plans for managing patients with diverticulitis effectively.
Understanding Diverticulitis
Diverticulitis occurs when small pouches (diverticula) in the digestive tract become inflamed or infected. These pouches most commonly form in the sigmoid colon, causing significant discomfort and potential complications if left untreated.
Clinical Manifestations
- Severe abdominal pain (typically left lower quadrant)
- Fever above 100.4°F (38°C)
- Nausea and vomiting
- Changes in bowel habits
- Abdominal tenderness
- Rectal bleeding
Nursing Assessment
Subjective Data Collection
- Pain characteristics and location
- Changes in bowel habits
- Dietary history
- Previous episodes
- Risk factors present
Objective Data Collection
- Vital signs monitoring
- Abdominal assessment
- Bowel sound evaluation
- Laboratory results review
- Diagnostic imaging interpretation
Primary Nursing Diagnoses
The following nursing care plans detail the most common nursing diagnoses for patients with diverticulitis:
1. Acute Pain
Nursing Diagnosis Statement:
Acute Pain related to the inflammatory process and increased pressure in the colon as evidenced by verbal reports of pain, guarding behavior, and changes in vital signs.
Related Factors:
- Inflammatory process
- Increased intestinal pressure
- Tissue damage
- Bacterial infection
Nursing Interventions and Rationales:
Assess pain characteristics using a standardized pain scale
- Enables proper pain management and evaluation of interventions
Administer prescribed analgesics
- Provides pain relief and comfort
Position patient for comfort
- Reduces abdominal pressure and discomfort
Monitor vital signs
- Indicates pain severity and treatment effectiveness
Desired Outcomes:
- The patient reports decreased pain levels
- Demonstrates improved comfort
- Shows stable vital signs
- Returns to normal activities
2. Risk for Deficient Fluid Volume
Nursing Diagnosis Statement:
Risk for Deficient Fluid Volume related to decreased oral intake, diarrhea, and vomiting.
Related Factors:
- Decreased oral intake
- Gastrointestinal losses
- NPO status
- Inflammatory process
Nursing Interventions and Rationales:
Monitor fluid intake and output
- Ensures adequate hydration
Assess skin turgor and mucous membranes
- Indicates hydration status
Administer IV fluids as ordered
- Maintains fluid balance
Monitor laboratory values
- Identifies electrolyte imbalances
Desired Outcomes:
- Maintains adequate hydration
- Shows stable vital signs
- Demonstrates normal skin turgor
- Reports no thirst
3. Impaired Bowel Elimination
Nursing Diagnosis Statement:
Impaired Bowel Elimination related to the inflammatory process and altered gut motility as evidenced by changes in bowel patterns.
Related Factors:
- Inflammatory process
- Dietary changes
- Medication side effects
- Physical inactivity
Nursing Interventions and Rationales:
Monitor bowel movements
- Identifies changes in elimination patterns
Implement bowel protocol
- Promotes regular elimination
Provide dietary modifications
- Supports healing and prevents complications
Encourage mobility as appropriate
- Promotes normal bowel function
Desired Outcomes:
- Establishes regular bowel pattern
- Reports no constipation or diarrhea
- Maintains adequate nutrition
4. Risk for Infection
Nursing Diagnosis Statement:
Risk for Infection related to compromised gut barrier and inflammatory process.
Related Factors:
- Compromised tissue integrity
- Inflammatory process
- Invasive procedures
- Immunocompromise
Nursing Interventions and Rationales:
Monitor temperature and vital signs
- Detects early signs of infection
Administer antibiotics as prescribed
- Treats existing infection
Maintain sterile technique
- Prevents secondary infection
Assess wound sites if present
- Identifies complications early
Desired Outcomes:
- Remains free from infection
- Maintains normal temperature
- Shows normal WBC count
- Demonstrates wound healing
5. Anxiety
Nursing Diagnosis Statement:
Anxiety related to acute illness and potential complications as evidenced by expressed concerns and increased tension.
Related Factors:
- Acute illness
- Uncertainty about prognosis
- Treatment regime
- Lifestyle changes
Nursing Interventions and Rationales:
Provide clear information about the condition
- Reduces fear and promotes understanding
Teach coping strategies
- Helps manage anxiety
Include family in care planning
- Enhances support system
Listen to concerns
- Validates feelings and builds trust
Desired Outcomes:
- Verbalizes decreased anxiety
- Demonstrates effective coping
- Participates in care
- Shows improved understanding
Patient Education
Essential topics for patient education include:
- Dietary modifications
- Medication management
- Lifestyle changes
- Warning signs
- Follow-up care
References
- Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.
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- Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
- Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
- Linzay CD, Pandit S. Acute Diverticulitis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459316/
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- Prasad SS, Potter M, Keely S, Talley NJ, Walker MM, Kairuz T. Roles of healthcare professionals in the management of chronic gastrointestinal diseases with a focus on primary care: A systematic review. JGH Open. 2019 Aug 27;4(2):221-229. doi: 10.1002/jgh3.12235. PMID: 32280768; PMCID: PMC7144774.
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