Case Study Acute Diverticulitis
Index Words: diverticulitis, assessment, risk factors, medications, crisis management
SCENARIO
T.H., a 57-year-old stockbroker, has come to the gastroenterologist for treatment of
recurrent mild to severe cramping in his abdomen and blood-streaked stool. You are
the nurse doing his initial workup. Your findings include a mildly obese man who
demonstrates moderate guarding of his abdomen with both direct and rebound
tenderness, especially in the left lower quadrant (LLQ). His vital signs are 168/98, 110,
24, and 100.40 F; he is slightly diaphoretic. T.H. reports that he has periodic constipation.
He has had previous episodes of abdominal cramping, but this time the pain is getting
worse.
Past medical history reveals that T.H. has a “sedentary job with lots of emotional
moments,” he has smoked a pack of cigarettes a day for 30 years, and he had “two to
three mixed drinks in the evening” until 2 months ago. He states, “I haven’t had anything
to drink in 2 months.” He denies having regular exercise: “just no time.” His diet consists
mostly of “white bread, meat, potatoes, and ice cream with fruit and nuts over it.” He
denies having a history of cardiac or pulmonary problems and has no personal history
of cancer, although his father and older brother died of colon cancer, he takes no
medications and denies the use of any other drugs or herbal products.
1. Identify four general health risk problems that T.H. exhibits.
a. Sedentary lifestyle, with no exercise
b. Smokes a pack of cigarettes a day for the last 30 years
c. Previous alcohol abuse
d. Family risk for colon cancer
2. Identify a key factor in his family history that might have profound implications
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, for his health and present state of mind.
a. T.H. has a familial history of colon cancer. Both his brother and his
father have died from colon cancer, and the patient is now of the age
where it typically develops, he needs to get screened.
3. Identify three key findings on his physical examination and indicate their
significance.
a. Tenderness in the abdomen indicates inflammation of the tissue or organ
below.
b. The patient is moderately guarding their abdomen throughout, this
indicates he is in pain.
Page | 2
Index Words: diverticulitis, assessment, risk factors, medications, crisis management
SCENARIO
T.H., a 57-year-old stockbroker, has come to the gastroenterologist for treatment of
recurrent mild to severe cramping in his abdomen and blood-streaked stool. You are
the nurse doing his initial workup. Your findings include a mildly obese man who
demonstrates moderate guarding of his abdomen with both direct and rebound
tenderness, especially in the left lower quadrant (LLQ). His vital signs are 168/98, 110,
24, and 100.40 F; he is slightly diaphoretic. T.H. reports that he has periodic constipation.
He has had previous episodes of abdominal cramping, but this time the pain is getting
worse.
Past medical history reveals that T.H. has a “sedentary job with lots of emotional
moments,” he has smoked a pack of cigarettes a day for 30 years, and he had “two to
three mixed drinks in the evening” until 2 months ago. He states, “I haven’t had anything
to drink in 2 months.” He denies having regular exercise: “just no time.” His diet consists
mostly of “white bread, meat, potatoes, and ice cream with fruit and nuts over it.” He
denies having a history of cardiac or pulmonary problems and has no personal history
of cancer, although his father and older brother died of colon cancer, he takes no
medications and denies the use of any other drugs or herbal products.
1. Identify four general health risk problems that T.H. exhibits.
a. Sedentary lifestyle, with no exercise
b. Smokes a pack of cigarettes a day for the last 30 years
c. Previous alcohol abuse
d. Family risk for colon cancer
2. Identify a key factor in his family history that might have profound implications
Page | 1
, for his health and present state of mind.
a. T.H. has a familial history of colon cancer. Both his brother and his
father have died from colon cancer, and the patient is now of the age
where it typically develops, he needs to get screened.
3. Identify three key findings on his physical examination and indicate their
significance.
a. Tenderness in the abdomen indicates inflammation of the tissue or organ
below.
b. The patient is moderately guarding their abdomen throughout, this
indicates he is in pain.
Page | 2
