NR507 Week 5: Discussion
Requirements:
- Read the case study below.
- In your initial discussion post, answer the questions related to the case scenario and support your response with at least one evidence-based reference by Wed., 11:59 pm MT.
- Respond to at least one peer and all faculty questions directed at you, using appropriate resources, before Sun., 11:59 pm MT.
Case Scenario:
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 findings, 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:
- Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
- Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis.
- List 3 risk factors for acute diverticulitis.
- Discuss why antibiotics and IV fluids are indicated in this case.
SOLUTION
1) Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
Diverticular disease or diverticulosis is characterized by pouch formation or herniation of the intestinal wall (McCance & Huether, 2019). A diverticulum is defined as a single pouch in the intestines. Common causes for diverticulosis are either increased pressure on the intestinal wall, or decreased strength of the wall itself (McCance et al., 2019). The four layers of mucosa…
2) Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis.
What is important to note is that the patient has an existing history of diverticular disease. Furthermore, the patient presents with left lower quadrant (LLQ) pain of the abdomen; a distended abdomen; constipation, nausea, and vomiting. Indicative of diverticulitis is also the assessment of faint and hypoactive bowel sounds. Hyper-resonance of the abdomen indicates air………..please follow the link below to purchase the solution at $10
