Abstract Flame

DIVERTICULITIS

DIAGNOSIS: Diverticulitis

(LAYMANS) DESCRIPTION:

Infection of the large intestine (usually sigmoid colon)

EXPECTED LENGTH OF STAY: 2-5 days

CARE OVERVIEW:

Patients typically present with left lower quadrant pain.  For mild disease, patients may be treated with oral antibiotics and pain medications for 7-10 days.  For moderate to severe disease, patients will require intravenous hydration, antibiotics, pain medications, and hospitalization.

COMMON THERAPIES: Laboratory studies typically include a complete blood count to assess for an elevation in the WBC count confirming inflammation and/or infection and a basic metabolic pain to assess hydration status and electrolytes.  An abdominal x-ray may be obtained to assess for obstruction. However, a CT scan of the abdomen and pelvis with IV contrast is the preferred imaging study to confirm the diagnosis of diverticulitis. Complications of diverticulitis include abscess, peritonitis, or fistula.  In rare cases, patients may need surgery. Patients typically require intravenous fluids for hydration, antibiotics, and pain control.

CARE MILESTONES: Most patients should show improvement after 2-3 days of treatment.  Criteria for discharge include resolution of pain (or significant improvement), improved WBC

count, and tolerance of an oral diet.

QUESTION PROMPTS FOR THE DOCTOR:

LABS: Daily labs obtained should include a complete blood count (to assess for improvement of the infection) and a basic metabolic panel (assess electrolytes and hydration status).

RADIOLOGY EXAMS: Abdominal x-ray and CT scan of the abdomen and pelvis with IV contrast.

MEDICATIONS: What are the risks for my antibiotics?  How long do you expect I will need an IV? How long will I need to take the pills?

QUESTION PROMPTS FOR THE NURSE: Will you be rounding on me hourly?  Will you do a bedside report at change of shift?  Ask them for the name of the medications, what they are for and what the side effects are when they are brought to you.

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