Diverticulitis Nursing Diagnosis Care Plan: Comprehensive Guide for Nurses

Diverticular disease encompasses a spectrum of conditions related to diverticula, which are small, bulging sacs that can form in the lining of the colon. Diverticulosis refers to the mere presence of these pouches and often goes unnoticed, remaining asymptomatic. However, when these diverticula become inflamed or infected, the condition progresses to diverticulitis, marked by noticeable and often painful symptoms. While diverticula can develop anywhere in the digestive tract, they are most commonly found in the sigmoid colon, the descending part of the large intestine, where weaknesses exist in the intestinal walls.

Nursing Process in Diverticulitis Management

The primary goal in diverticulitis treatment is to allow the colon to heal and the inflammation to subside. Treatment strategies vary depending on the severity of the condition. Some patients with mild symptoms can be effectively managed at home with oral antibiotics, pain relievers, rest, and dietary modifications, specifically a clear liquid diet. However, hospitalization becomes necessary for individuals experiencing more severe symptoms or complications.

Surgical intervention may be required for patients with recurrent diverticulitis attacks or when complications arise. Surgery typically involves the resection (removal) of the diseased portion of the colon, followed by a primary anastomosis, where the healthy ends of the colon are reconnected. In situations where primary anastomosis is not feasible, a temporary diverting colostomy may be performed. This procedure reroutes stool away from the healing colon. Once the colon has recovered, the colostomy can be reversed, and bowel continuity restored.

Patient education is a cornerstone of diverticulitis management. Nurses play a vital role in providing patients with comprehensive information about their condition, treatment plans, and necessary lifestyle adjustments, particularly regarding diet and fluid intake. A thorough understanding of the disease process and diligent adherence to the treatment plan are crucial in preventing complications and future exacerbations.

Nursing Assessment for Diverticulitis

The initial phase of nursing care is a thorough nursing assessment. This involves gathering comprehensive data, including physical, psychosocial, emotional, and diagnostic information. In the context of diverticulitis, this assessment focuses on identifying both subjective and objective signs and symptoms to inform the nursing diagnosis and subsequent care plan.

Review of Health History: Subjective Data Collection

1. Eliciting General Symptoms:

• Diverticulosis: It’s important to understand that diverticulosis often presents with minimal to no symptoms. However, some patients may report vague gastrointestinal discomfort, which can overlap with symptoms of other GI disorders. Inquire about:

  • Abdominal cramping or discomfort: Characterize the nature, location, and duration of cramps.
  • Tenderness over the affected area: Ask patients to pinpoint areas of tenderness.
  • Bloating or abdominal swelling: Assess the onset and progression of bloating.
  • Changes in bowel habits, specifically constipation or difficulty passing stool.

• Diverticulitis: Symptoms are more pronounced and indicative of inflammation or infection. Key symptoms to assess include:

  • Acute abdominal pain: This is a hallmark symptom. Determine the pain’s onset, location (typically left lower quadrant), severity (using a pain scale), character (sharp, cramping, constant), and any aggravating or relieving factors.
  • Abdominal distention: Observe for visible distention and measure abdominal girth if necessary.
  • Decreased or absent bowel sounds: Auscultate bowel sounds in all four quadrants to identify any abnormalities.
  • Nausea and vomiting: Assess the frequency, amount, and characteristics of emesis.
  • Chills and fever: Monitor temperature for elevation, which suggests infection.
  • Constipation or diarrhea: Inquire about changes in bowel frequency and consistency.
  • Rectal bleeding: Ask about the presence and amount of rectal bleeding, and characterize the stool (e.g., presence of bright red blood, melena).

2. Investigating Changes in Bowel Habits:

• Detailed questioning about bowel habits is crucial. Changes in frequency, consistency, and ease of passage can provide valuable clues.
• Explore the onset and duration of any altered bowel habits.
• Investigate potential causes of nausea and vomiting, such as bowel obstruction, a known complication of diverticulitis.

3. Determining Risk Factors:

• Identifying risk factors helps understand the patient’s predisposition to diverticular disease and guide preventive strategies.

• Non-modifiable Risk Factors:

  • Ethnicity: Emphasize the higher prevalence of diverticulosis in Western populations.
  • Age: Diverticular disease is strongly age-related, with incidence increasing significantly after age 40.

• Modifiable Risk Factors:

  • Smoking: Highlight smoking as a significant risk factor for diverticulitis due to its negative impact on colon mucus production and overall vascular health.
  • Physical inactivity: Discuss the protective effect of regular physical activity against diverticular disease complications.
  • Diet: Thoroughly assess dietary habits, particularly intake of fiber and fat. Emphasize the link between low-fiber, high-fat diets and the development of diverticulosis and diverticulitis. Constipation resulting from low fiber intake increases pressure in the colon, promoting diverticula formation.
  • Obesity: Recognize obesity as an inflammatory state and its association with altered gut microbiota, both contributing to diverticulitis risk.

4. Medication History – NSAID Use:

• Specifically inquire about the regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin. Regular NSAID use is linked to an increased risk of both diverticulitis and diverticular bleeding.

Physical Assessment: Objective Data Collection

1. Temperature Monitoring:

• Regularly monitor the patient’s temperature. Fever, defined as 100.4°F (38.0°C) or higher, is a key indicator of infection associated with diverticulitis.

2. Abdominal Palpation:

• Perform careful abdominal palpation, starting gently and progressing deeper.
• Assess for tenderness, noting the location and severity. Diverticulitis typically causes localized tenderness, often most pronounced in the left lower quadrant.
• Evaluate for rebound tenderness, rigidity, and guarding, which are signs of peritoneal irritation and potential bowel wall perforation, a serious complication.
• Palpate for any palpable abdominal masses, which could indicate an abscess formation.

3. Auscultation of Bowel Sounds:

• Auscultate bowel sounds in all four quadrants.
• Document the presence, absence, or characteristics of bowel sounds. Bowel sounds may be normal or hypoactive in diverticulitis. Absent bowel sounds may suggest ileus or obstruction.

4. Rectal Examination:

• A digital rectal examination may be performed to assess the rectal mucosa and rule out other rectal abnormalities.
• Check for the presence of rectal bleeding and assess stool consistency.

Diagnostic Procedures and Data

1. Incidental Discovery of Diverticulosis:

• Recognize that diverticulosis is often diagnosed incidentally during routine colonoscopies or abdominal imaging performed for other reasons, as it is frequently asymptomatic.

2. Stool Sample Analysis:

• Obtain stool samples as ordered for laboratory analysis.
• Stool studies are crucial to rule out other causes of gastrointestinal symptoms, such as bacterial or parasitic infections. This helps differentiate diverticulitis from other infectious diarrheal illnesses.

3. Laboratory Blood Tests:

• Review laboratory results, particularly blood tests, which provide valuable diagnostic information.
  • Complete Blood Count (CBC): Assess for signs of infection (leukocytosis – elevated white blood cell count) and bleeding (anemia – low hemoglobin level).
  • C-Reactive Protein (CRP): Elevated CRP levels indicate an inflammatory process, supporting the diagnosis of diverticulitis.

4. Imaging Procedures:

• Imaging scans are essential to visualize the colon and confirm the diagnosis of diverticulitis, assess its severity, and identify complications.
  • Computed Tomography (CT) Scan: CT scans are the gold standard for diagnosing diverticulitis. They effectively visualize inflamed diverticula, thickening of the bowel wall, and complications like abscesses, perforations, and fistulas.
  • Barium Enema: While less common now due to CT availability, barium enema (contrast X-ray of the colon) can detect diverticula but is less sensitive for acute diverticulitis and may be contraindicated in acute inflammation due to risk of perforation.
  • Ultrasonography: Ultrasound can be used to diagnose diverticulitis, particularly in thinner patients, but it may not visualize larger abscesses as effectively as CT scans. It is often used as an initial imaging modality in some settings due to its accessibility and lack of radiation.

5. Colon Visualization Procedures:

• Procedures that directly visualize the colon are used for diagnosis and to rule out other conditions.
  • Colonoscopy: Colonoscopy is typically performed 6 to 8 weeks after the acute diverticulitis symptoms have subsided. It allows for direct visualization of the entire colon to confirm diverticulosis, assess the extent of inflammation, and, importantly, rule out other conditions such as colorectal cancer, inflammatory bowel disease (IBD), or colitis, which can mimic diverticulitis. Colonoscopy is contraindicated in acute diverticulitis due to the risk of perforation.
  • Sigmoidoscopy: Sigmoidoscopy, a less invasive procedure visualizing only the sigmoid colon and rectum, may be used in some cases, particularly to assess for inflammation in the most common location of diverticula. Like colonoscopy, it is generally avoided in the acute phase.

Nursing Interventions for Diverticulitis

Nursing interventions are critical in managing diverticulitis, alleviating symptoms, preventing complications, and promoting patient recovery. These interventions are tailored to the patient’s condition, ranging from conservative management to more aggressive treatments.

Managing Inflammation

1. Diverticulosis Management:

• Reassure patients that diverticulosis, when asymptomatic, usually requires no specific medical treatment.
• Emphasize lifestyle modifications to prevent progression to diverticulitis, focusing on dietary changes.

2. Diverticulitis Prevention:

• Educate patients about the importance of a high-fiber diet as a primary preventative measure against diverticulitis.
• Recommend increasing consumption of fiber-rich foods like fruits, vegetables, and whole grains to promote regular bowel movements and prevent constipation, a key factor in diverticula formation and inflammation.

3. Bowel Rest for Mild Diverticulitis:

• For uncomplicated, mild diverticulitis, bowel rest is often the initial treatment.
• Implement a clear liquid diet for several days to reduce bowel stimulation and allow inflammation to subside.
• Advise patients on the gradual reintroduction of solid foods as symptoms improve, starting with low-fiber options and progressing to a high-fiber diet for long-term management.

Assisting with Medical and Surgical Treatment

1. Bowel Rest for Complicated Diverticulitis (NPO Status):

• For complicated diverticulitis, complete bowel rest (NPO – nothing by mouth) is usually necessary to minimize colonic activity and promote healing.
• Manage nutritional needs through total parenteral nutrition (TPN) to provide necessary nutrients while the patient is NPO.

2. Antibiotic Administration:

• Administer antibiotics as prescribed to combat bacterial infection.
• For outpatient management of mild diverticulitis, oral antibiotics are typically prescribed to target gram-negative and anaerobic bacteria commonly involved in diverticulitis. Common regimens may include quinolones (e.g., ciprofloxacin) or sulfa drugs (e.g., trimethoprim/sulfamethoxazole) combined with metronidazole, or amoxicillin-clavulanate as a single agent. Treatment duration is usually 7 to 10 days.
• For hospitalized patients with complicated diverticulitis (e.g., perforation, abscess), intravenous antibiotics are essential for more aggressive infection control.

3. Preoperative and Postoperative Surgical Care:

• Prepare patients for potential surgical interventions if complications like peritonitis, fistulas, or bowel perforation occur, or for recurrent severe diverticulitis.
• Explain the surgical procedures, which may include bowel resection (removal of the diseased segment of the colon), often performed laparoscopically in less severe cases.
• In severe cases with extensive inflammation, a staged approach may be necessary, initially creating a diverting colostomy to allow healing, followed by a later surgery to reconnect the colon.
• Provide comprehensive postoperative care, including pain management, wound care, ostomy care if applicable, and monitoring for complications like infection or anastomotic leak.

4. Abscess Drainage Assistance:

• Assist with percutaneous drainage of abscesses, a common complication of diverticulitis.
• Prepare the patient for the procedure, which involves a radiologically guided (CT or ultrasound) insertion of a catheter through the abdominal wall into the abscess cavity to drain pus.
• Provide post-drainage care, including monitoring drainage output, maintaining catheter patency, and assessing for signs of infection.

Preventing Recurrent Episodes: Long-Term Management

1. Dietary Modifications: High-Fiber Diet:

• Emphasize the crucial role of a long-term high-fiber diet in preventing recurrent diverticulitis.
• Educate patients on incorporating high-fiber foods into their daily meals, such as fresh fruits and vegetables, whole grain pasta and bread, beans, and legumes.
• Advise on limiting red meat intake, as some studies suggest a correlation with increased diverticulitis risk.

2. Hydration:

• Stress the importance of adequate fluid intake, aiming for at least 1.5 to 2 liters of water per day, unless contraindicated by other medical conditions.
• Explain that fiber absorbs water, and adequate hydration helps maintain soft stools, easing passage and reducing pressure in the colon.

3. Exercise and Weight Management:

• Encourage regular physical activity as tolerated to promote bowel regularity and overall health.
• For overweight or obese patients, emphasize the benefits of weight loss in reducing the risk of recurrent and complicated diverticulitis.

4. Smoking Cessation:

• Strongly advise patients who smoke to quit, highlighting the association between smoking and worse outcomes in diverticulitis.

5. Re-evaluation of Dietary Restrictions: Nuts and Seeds:

• Inform patients that current evidence no longer supports the traditional recommendation to avoid nuts, seeds, and popcorn. Recent research indicates these foods are not associated with increased diverticulitis risk and may even be part of a healthy, high-fiber diet.

6. Fiber and Probiotic Supplements:

• Discuss the potential benefits of fiber supplements like psyllium (Metamucil) for patients who struggle to achieve adequate fiber intake through diet alone.
• Consider recommending probiotic supplements, as some studies suggest they may help in preventing diverticulitis recurrence by promoting a healthy gut microbiome, although more research is ongoing in this area.

Diverticulitis Nursing Care Plans: Addressing Common Nursing Diagnoses

Nursing care plans are essential tools for organizing and delivering patient-centered care. They prioritize nursing diagnoses, outline expected outcomes, and guide nursing interventions. Here are examples of nursing care plans for common nursing diagnoses associated with diverticulitis:

Acute Pain Nursing Care Plan

Nursing Diagnosis: Acute Pain related to disease process and inflammatory process.

Defining Characteristics:

• Reports of abdominal pain and tenderness, typically in the left lower quadrant.
• Pain described as sharp, constant, or cramping, potentially radiating.
• Facial grimacing, guarding behavior, and protective positioning.
• Diaphoresis and distraction behaviors.

Expected Outcomes:

• Patient will report a significant reduction in pain intensity using a pain scale (e.g., from 8/10 to 3/10) within a specified timeframe (e.g., within 24-48 hours).
• Patient will demonstrate relaxed facial expression and reduced guarding behavior.
• Patient will maintain stable vital signs (blood pressure, heart rate) within normal limits for their baseline, indicating pain management effectiveness.

Nursing Assessments:

• 1. Pain Assessment:
  • Thoroughly assess pain characteristics: onset, location, duration, character, aggravating/relieving factors, and radiation. Use a pain scale (0-10) to quantify pain intensity.
• 2. Review Diagnostic Findings:
  • Monitor laboratory results (WBC, CRP, ESR) for markers of inflammation and infection.
  • Review CT scan reports for confirmation of diverticulitis and assessment of severity.

Nursing Interventions:

• 1. Administer Medications:
  • Administer prescribed analgesics (e.g., opioids, non-opioids) on a scheduled and PRN (as needed) basis to manage pain.
  • Administer antibiotics as ordered to treat the underlying infection contributing to pain.
• 2. Dietary Management:
  • Provide a clear liquid or soft diet as ordered to reduce bowel stimulation and inflammation.
  • Maintain NPO status if indicated for bowel rest in severe cases.
• 3. Promote Rest:
  • Encourage bed rest to minimize intra-abdominal pressure and reduce pain exacerbation.
  • Advise patient to avoid activities that increase intra-abdominal pressure (straining, heavy lifting, tight clothing).
• 4. Non-pharmacological Pain Relief:
  • Implement non-pharmacological pain management techniques: distraction, relaxation techniques, guided imagery, music therapy, heat or cold applications (with caution and doctor’s order).
• 5. Prepare for Surgical Interventions:
  • If surgical intervention is indicated, provide preoperative education and emotional support.

Constipation Nursing Care Plan

Nursing Diagnosis: Constipation related to insufficient fiber intake, insufficient fluid intake, decreased physical activity, and potential blockage of the colon due to inflammation.

Defining Characteristics:

• Reports of straining with defecation, sensation of incomplete evacuation, and anorectal obstruction.
• Infrequent bowel movements (less than 3 per week), hard stools.
• Need for manual stool evacuation, inability to defecate, and potential rectal bleeding.

Expected Outcomes:

• Patient will report passing stool without straining by discharge.
• Patient will report having at least one bowel movement every 1-3 days within their normal pattern.
• Patient will verbalize understanding of dietary and lifestyle modifications to prevent constipation.

Nursing Assessments:

• 1. Dietary and Fluid Intake Assessment:
  • Assess the patient’s typical daily fiber and fluid intake.
  • Identify dietary habits that contribute to low fiber intake (e.g., processed foods, low fruit/vegetable consumption).
• 2. Bowel Habit Assessment:
  • Detailed assessment of current and past bowel habits: frequency, consistency, ease of passage, use of laxatives, and any perceived changes.

Nursing Interventions:

• 1. Bowel Habit Diary:
  • Encourage the patient to keep a bowel habit diary to track patterns, consistency, and effectiveness of interventions.
• 2. High-Fiber Diet Education:
  • Educate the patient on the importance of a high-fiber diet for long-term bowel health.
  • Provide examples of high-fiber foods: fruits, vegetables, whole grains, beans, legumes, nuts, and seeds (if tolerated and advised).
• 3. Encourage Fluid Intake:
  • Promote adequate fluid intake (1.5-2 liters/day) to soften stools and facilitate passage.
• 4. Promote Physical Activity:
  • Encourage physical activity as tolerated to stimulate bowel peristalsis.
• 5. Bowel Training Education:
  • Educate on healthy bowel habits: responding to the urge to defecate promptly, allowing adequate time and privacy for bowel movements, and establishing a regular toileting routine.
• 6. Stool Softeners/Laxatives (as ordered):
  • Administer stool softeners or bulk-forming laxatives as prescribed to manage constipation, especially during recovery and long-term management. Avoid stimulant laxatives unless specifically ordered and for short-term use.

Diarrhea Nursing Care Plan

Nursing Diagnosis: Diarrhea related to infectious and inflammatory processes associated with diverticulitis.

Defining Characteristics:

• Frequent, loose, watery stools.
• Abdominal pain, cramping, and bowel urgency.
• Hyperactive bowel sounds.
• Potential dehydration (dry mucous membranes, decreased skin turgor, tachycardia, hypotension).

Expected Outcomes:

• Patient will exhibit formed stools without bowel urgency within a reasonable timeframe (e.g., 24-72 hours).
• Patient will verbalize at least two strategies to prevent dehydration associated with diarrhea.
• Patient will maintain adequate hydration as evidenced by moist mucous membranes, good skin turgor, and stable vital signs.

Nursing Assessments:

• 1. Stool Pattern and Characteristics:
  • Assess the frequency, consistency, volume, and characteristics of stools.
  • Document any associated symptoms like abdominal pain, cramping, or urgency.
• 2. Stool Tests Review:
  • Review stool test results for infectious agents (bacteria, parasites, C. difficile toxin) to guide treatment.
• 3. CT Scan Review:
  • Correlate diarrhea with CT scan findings to assess the severity of diverticulitis and rule out complications.
• 4. Dehydration Monitoring:
  • Monitor for signs and symptoms of dehydration: vital signs (tachycardia, hypotension), mucous membrane dryness, skin turgor, urine output, and electrolyte imbalances.

Nursing Interventions:

• 1. Medication Administration:
  • Administer prescribed antidiarrheal medications (e.g., loperamide, diphenoxylate/atropine) if appropriate and ordered.
  • Administer antibiotics as ordered to treat bacterial infection contributing to diarrhea.
• 2. Dietary Management:
  • Initially, implement a liquid diet to rest the bowel.
  • Gradually reintroduce solid foods as diarrhea resolves, starting with bland, low-fiber options (BRAT diet: bananas, rice, applesauce, toast) and progressing as tolerated.
• 3. Dietary Fiber Management:
  • During acute diarrhea, temporarily decrease fiber intake to reduce bowel stimulation.
  • Once diarrhea resolves, educate on gradually increasing fiber intake for long-term bowel health.
• 4. Fluid and Electrolyte Monitoring and Replacement:
  • Strictly monitor fluid intake and output.
  • Monitor electrolyte levels (sodium, potassium) and report abnormalities.
  • Encourage oral rehydration with electrolyte-rich solutions (oral rehydration solutions, broths, sports drinks).
  • Administer intravenous fluids as ordered to correct dehydration and electrolyte imbalances.

Imbalanced Nutrition: Less Than Body Requirements Nursing Care Plan

Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements related to inability to absorb nutrients due to inflammatory response, decreased oral intake due to pain, nausea, and bowel rest.

Defining Characteristics:

• Insufficient dietary intake, poor appetite, reported inadequate knowledge of nutrient requirements.
• Potential weight loss, muscle wasting (in prolonged cases).
• Laboratory evidence of nutritional deficits (decreased prealbumin, albumin).

Expected Outcomes:

• Patient will maintain or progress towards an adequate weight for their body frame.
• Patient will demonstrate understanding of appropriate food choices for diverticulitis management, including high-fiber diet in remission and appropriate dietary modifications during acute episodes.
• Patient will exhibit improved appetite and oral intake as symptoms resolve.

Nursing Assessments:

• 1. Nutritional History:
  • Detailed assessment of patient’s usual dietary habits, food preferences, and any dietary restrictions or intolerances.
  • Identify factors affecting nutritional intake: pain, nausea, NPO status, knowledge deficits.
• 2. Laboratory Values Review:
  • Monitor prealbumin and albumin levels as indicators of nutritional status and inflammatory response.
• 3. Barriers to Adequate Nutrition:
  • Assess for barriers to achieving adequate nutrition: financial constraints, lack of access to healthy foods, food preparation difficulties, inadequate knowledge about nutrition.

Nursing Interventions:

• 1. Parenteral Nutrition (TPN) Administration:
  • Administer TPN as ordered for patients who are NPO and unable to meet nutritional needs enterally.
• 2. Symptom Management:
  • Administer antiemetics and pain medications as prescribed to alleviate nausea and pain, thereby improving appetite.
  • Coordinate medication administration before meals to maximize oral intake.
• 3. Identify Food Preferences:
  • Inquire about patient’s food preferences and incorporate them into dietary plans as appropriate, considering dietary restrictions and recommendations for diverticulitis.
• 4. Nutritional Education:
  • Provide comprehensive education on proper nutrition for diverticulitis management, including the importance of a high-fiber diet in remission and appropriate dietary modifications during acute flares (clear liquids, low-fiber diet initially).
  • Offer dietary counseling and resources (registered dietitian consultation) as needed.
• 5. Fiber Supplements (with caution):
  • Discuss the potential use of fiber supplements (psyllium, methylcellulose) as adjuncts to dietary fiber intake, especially for long-term management.
  • Emphasize that fiber supplements should generally be avoided during acute diverticulitis flares and introduced gradually during remission.

Ineffective Tissue Perfusion (Gastrointestinal) Nursing Care Plan

Nursing Diagnosis: Ineffective Tissue Perfusion (Gastrointestinal) related to inflammatory process, fecal obstruction, abscess formation, and potential fistula formation in diverticulitis.

Defining Characteristics:

• Abdominal tenderness, cramping, distention, and bloating.
• Decreased or absent bowel sounds, constipation or diarrhea.
• Nausea and vomiting.
• In severe cases: signs of sepsis, hypotension, peritonitis.

Expected Outcomes:

• Patient will maintain adequate gastrointestinal tissue perfusion as evidenced by resolution of abdominal distention, return of normal bowel sounds, and absence of severe abdominal pain.
• Patient will remain free from gastrointestinal tissue perfusion complications such as intestinal perforation, obstruction, peritonitis, and sepsis.

Nursing Assessments:

• 1. Elimination Patterns and Bowel Sounds:
  • Monitor bowel elimination patterns (frequency, consistency).
  • Auscultate bowel sounds frequently to detect changes (hypoactive, absent, hyperactive).
• 2. Symptom Monitoring:
  • Closely monitor for changes in symptoms, particularly worsening abdominal pain, fever, chills, nausea, vomiting, and signs of peritonitis (rigid abdomen, rebound tenderness).
• 3. Abdominal Assessment:
  • Regularly assess the abdomen for distention, tenderness, guarding, and rebound tenderness.

Nursing Interventions:

• 1. Laboratory Monitoring:
  • Monitor WBC count, CRP levels, and other inflammatory markers to assess infection and inflammation.
  • Monitor hemoglobin and hematocrit for signs of bleeding.
• 2. Vital Signs Monitoring:
  • Frequent monitoring of vital signs (heart rate, blood pressure, temperature, respiratory rate) to detect early signs of complications such as sepsis, hypovolemia, and shock.
• 3. Medication Administration:
  • Administer antibiotics as ordered to treat infection and improve tissue perfusion.
  • Administer analgesics to manage pain and reduce stress response.
  • Administer intravenous fluids to maintain hydration and hemodynamic stability.
• 4. Bowel Rest Implementation:
  • Enforce bowel rest (NPO status) as ordered to reduce intestinal workload and promote healing.
  • Explain the rationale for bowel rest to the patient to enhance adherence.
• 5. Prepare for Surgical Intervention:
  • Prepare the patient for potential surgical interventions (resection, colostomy) if complications like peritonitis, perforation, or obstruction develop. Ensure timely communication with the surgical team and provide pre-operative and post-operative care as indicated.

References

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