Case Study: solved an 84 year old female who has a history of diverticular disheroease course heroCase Study: solved an 84 year old female who has a history of diverticular disease course

Case Study: solved an 84 year old female who has a history of diverticular disheroease course heroCase Study: solved an 84 year old female who has a history of diverticular disease course An 84- year-old -female who has a history of diverticular disease presents to the clinic with left lower quadrant (LLQ) pain Question Answer & Explanation Related Questions Related Courses 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 (100.20F) 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. Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis. the clinical flndings from the case that supports a diagnosis of acute diverticulitis present with lwith left lower quadrant (LLQ) Find study resources 숿 pain of the abdomen that is accompanied by with constipation, nausea, vomiting and a low-grade fever rated 100.20 F for 1 day, Question Answer & Explanation Related Questions Related Courses others include tenderness, anorexia, constipation, nausea, diarrhea, and dysuria. has signs of dehydration (pale mucosa, poor skin turgor with mild hypotension 90/60 mmHg and tachycardia rated 101 bpm. Initial laboratory studies include a complete blood count, basic metabolic panel, urinalysis, and measurement of C-reactive protein. 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 and small bowel in distended. Computed tomography, the most commonly performed imaging test, is useful to establish the diagnosis and the extent and severity of disease and to exclude complications in selected patients. Colonoscopy is recommended four to six weeks after resolution of symptoms for patients with the complicated disease or another indication, such as age-appropriate screening. In mild, uncomplicated diverticulitis, antibiotics do not accelerate recovery or prevent complications or recurrences. Hospitalization should be considered if patients have signs of peritonitis or there is suspicion of complicated diverticulitis. List 3 risk factors for acute diverticulitis. 1. Diet appears to play a signiflcant role. Low flber, high fat, and red meat diets may increase the risk for development of diverticulosis and possible diverticulitis. Eating a diet high in red and processed meats could increase your risk for developing diverticulitis. On the other hand, a diet high in fruits, vegetables, and whole grains is associated with a decreased risk. 2. Obesity and smoking are known to increase the potential for both diverticulitis and diverticular bleeding. Obesity is associated with more frequent diverticulitis readmissions, increased ICU admission, and higher mortality due to increased BMI, waist circumference, and waist-to-hip ratio were associated with an increased risk of self-reported diverticulitis 3. Exposure to some drugs including nonsteroidal anti-inflammatory drugs like NSAIDs, steroids, and opiates are associated with diverticulitis. Exposure to statin drugs may decrease the incidence of symptomatic diverticulitis. Despite a common popular belief, nuts, seeds, and popcorn are not associated with increased risk of diverticulosis, diverticulitis, or diverticular bleeding. Discuss why antibiotics and IV fluids are indicated in this case. Antibiotic is indicated to this case to treat complication like bowel abscess, flstula or obstruction, or a puncture called perforation in the bowel wall. Multiple episodes of uncomplicated diverticulitis may weakened immune system. If the symptoms don't improve within a few days, the risk of serious complications increases. Surgery is recommended, people who already have an intestinal perforation or peritonitis need to have surgery immediately both of these conditions are medical emergencies. A typical oral antibiotic regimen is a combination of ciprofloxacin or trimethoprim-sulfamethoxazole and metronidazole. Monotherapy with moxifloxacin or amoxicillin/clavulanic acid are appropriate for outpatient treatment of uncomplicated diverticulitis. IV Fluids is indicated to this case to diagnose diverticulitis using a computed tomography (CT) scan of your abdomen and pelvis. It is best to perform the scan with intravenous contrast when possible. Many centers will also ask patient to drink a form of oral contrast. Both contrast materials make the intestinal tract easier to see. References: Sandler RS, Everhart J E, Donowitz M, et al. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122(5):. Finney J MT. Diverticulitis and its surgical treatment. Proc Interstate Post-Grad Med Assembly North Am. 1928;55:57-65. Spriggs E I, Marxer O A. Intestinal diverticula. Q J Med. 1925;19:1. Cruveilhier S. Traite de'anatomie pathologique. Balliere et Cie. 1849;1:592-593. Hi, I hope this can help you. Keep doing what you love and do the things that motivate you. Always aim high, Keep safe. God bless :) An 84- year-old -female who has a history of diverticular disease presents to the clinic with left lower quadrant (LLQ) pain Question Answer & Explanation Related Questions Related Courses 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 (100.20F) 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. Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis. the clinical flndings from the case that supports a diagnosis of acute diverticulitis present with lwith left lower quadrant (LLQ) Find study resources 숿 pain of the abdomen that is accompanied by with constipation, nausea, vomiting and a low-grade fever rated 100.20 F for 1 day, Question Answer & Explanation Related Questions Related Courses others include tenderness, anorexia, constipation, nausea, diarrhea, and dysuria. has signs of dehydration (pale mucosa, poor skin turgor with mild hypotension 90/60 mmHg and tachycardia rated 101 bpm. Initial laboratory studies include a complete blood count, basic metabolic panel, urinalysis, and measurement of C-reactive protein. 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 and small bowel in distended. Computed tomography, the most commonly performed imaging test, is useful to establish the diagnosis and the extent and severity of disease and to exclude complications in selected patients. Colonoscopy is recommended four to six weeks after resolution of symptoms for patients with the complicated disease or another indication, such as age-appropriate screening. In mild, uncomplicated diverticulitis, antibiotics do not accelerate recovery or prevent complications or recurrences. Hospitalization should be considered if patients have signs of peritonitis or there is suspicion of complicated diverticulitis. List 3 risk factors for acute diverticulitis. 1. Diet appears to play a signiflcant role. Low flber, high fat, and red meat diets may increase the risk for development of diverticulosis and possible diverticulitis. Eating a diet high in red and processed meats could increase your risk for developing diverticulitis. On the other hand, a diet high in fruits, vegetables, and whole grains is associated with a decreased risk. 2. Obesity and smoking are known to increase the potential for both diverticulitis and diverticular bleeding. Obesity is associated with more frequent diverticulitis readmissions, increased ICU admission, and higher mortality due to increased BMI, waist circumference, and waist-to-hip ratio were associated with an increased risk of self-reported diverticulitis 3. Exposure to some drugs including nonsteroidal anti-inflammatory drugs like NSAIDs, steroids, and opiates are associated with diverticulitis. Exposure to statin drugs may decrease the incidence of symptomatic diverticulitis. Despite a common popular belief, nuts, seeds, and popcorn are not associated with increased risk of diverticulosis, diverticulitis, or diverticular bleeding. Discuss why antibiotics and IV fluids are indicated in this case. Antibiotic is indicated to this case to treat complication like bowel abscess, flstula or obstruction, or a puncture called perforation in the bowel wall. Multiple episodes of uncomplicated diverticulitis may weakened immune system. If the symptoms don't improve within a few days, the risk of serious complications increases. Surgery is recommended, people who already have an intestinal perforation or peritonitis need to have surgery immediately both of these conditions are medical emergencies. A typical oral antibiotic regimen is a combination of ciprofloxacin or trimethoprim-sulfamethoxazole and metronidazole. Monotherapy with moxifloxacin or amoxicillin/clavulanic acid are appropriate for outpatient treatment of uncomplicated diverticulitis. IV Fluids is indicated to this case to diagnose diverticulitis using a computed tomography (CT) scan of your abdomen and pelvis. It is best to perform the scan with intravenous contrast when possible. Many centers will also ask patient to drink a form of oral contrast. Both contrast materials make the intestinal tract easier to see. References: Sandler RS, Everhart J E, Donowitz M, et al. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122(5):. Finney J MT. Diverticulitis and its surgical treatment. Proc Interstate Post-Grad Med Assembly North Am. 1928;55:57-65. Spriggs E I, Marxer O A. Intestinal diverticula. Q J Med. 1925;19:1. Cruveilhier S. Traite de'anatomie pathologique. Balliere et Cie. 1849;1:592-593. Hi, I hope this can help you. Keep doing what you love and do the things that motivate you. Always aim high, Keep safe. God bless :)