Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis Essay.

Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis Essay.

Diverticular disease is characterized by pouch-like herniations (diverticula) of the mucosa that usually develop in the muscular wall of any portion of the gut, mainly the colon. Diverticula develop at points of weakness in the intestinal wall, mostly in areas where blood vessels interrupt the muscle layer (Tursi et al., 2020). Diverticulitis occurs when one or more diverticula become inflamed. This develops when bacteria or undigested food gets trapped in a diverticulum, and blood supply to that area is impaired. Bacteria colonize the diverticulum, resulting in diverticulitis, which can perforate and cause a local abscess (Strate & Morris, 2019). Diverticulosis is mostly asymptomatic, but pain and bleeding can occur. Diverticulitis presents with nausea, vomiting, low-grade fever, tachycardia, constipation, and LLQ pain. Physical findings include hypo- or hyperactive bowel sounds, abdominal distention, localized abdominal tenderness, and a tender mass.

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Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis.

The patient in the case study has positive symptoms of acute diverticulitis like LLQ abdominal pain, low-grade fever (100.20F), nausea, vomiting, constipation, tachycardia, distended abdomen, faint and hypoactive bowel sounds, and LLQ abdominal tenderness. In addition, a distended small bowel on an abdominal CT scan supports acute diverticulitis.

List 3 risk factors for acute diverticulitis.

The risk factors for acute diverticulitis include aspirin and non-steroidal inflammatory drug (NSAID) use, consumption of a high-fat and low-fiber diet, and obesity (Strate & Morris, 2019).

Discuss why antibiotics and IV fluids are indicated in this case

The patient has an ileus on the abdominal x-ray indicating complicated diverticulitis. IV antibiotics and fluids are indicated for complicated diverticulitis cases (Strate & Morris, 2019). IV antibiotics will be vital to treat the infection, while IV fluid therapy will manage the dehydration and correct mild hypotension.

References

Strate, L. L., & Morris, A. M. (2019). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 156(5), 1282–1298. https://doi.org/10.1053/j.gastro.2018.12.033

Tursi, A., Scarpignato, C., Strate, L. L., Lanas, A., Kruis, W., Lahat, A., & Danese, S. (2020). Colonic diverticular disease. Nature reviews. Disease primers, 6(1), 20. https://doi.org/10.1038/s41572-020-0153-5

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This is a graded discussion: 100 points possible

Week 5: Discussion

Purpose

due Feb 12

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Compare and contrast the pathophysiology of diverticular disease (diverticulosis) and acute (CO1)
2. Identify risk factors for acute diverticulitis and the clinical signs and symptoms associated with the

• (CO3)

3. Explain the significance of physical exam and diagnostic findings in the diagnosis of diverticular

disease. (CO4)

Due Date:

Initial post is due on Wednesday by 11:59 p.m. MT. All posts are due by Sunday, 11:59 p.m. MT

A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.

Total Points Possible: 100 Requirements:

1. Read the case study
2. 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 , 11:59 pm MT.
3. Provides a minimum of two responses weekly on separate days; g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question 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:

1. Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and
2. Identify the clinical findings 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.

Category	Points	%	Description
Application of Course Knowledge	30	30%	The student:
			Compares and contrasts the pathophysiology between diverticular disease (diverticulosis) and acute diverticulitis.

Category

Points                              %

Description

Identifies the clinical findings from the case that supports a diagnosis of acute diverticulitis.

Lists 3 risk factors for acute diverticulitis.

Discusses why antibiotics and IV fluids are indicated in this case.

Support from

Evidence-Based                 30

Practice

30%

Initial discussion post is supported with appropriate, scholarly sources; AND

Sources are published within the last 5 years (unless it is the most current

CPG); AND

Reference list is provided and in- text citations match; AND

All answers are fully supported with an

appropriate EBM argument

Interactive Dialogue          30

30%

In addition to providing a response to the initial post due by Wednesday, 11:59 p.m. MT, student provides a minimum of two responses weekly

 

Category	Points	%	Description
			on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question. A response to faculty could include a question posed to a student or the entire class or a faculty question directed towards another student. AND   Evidence from appropriate scholarly sources are included; AND Reference list is provided and in- text citations match
	90	90%	Total CONTENT Points= 90 pts
DISCUSSION FORMAT
Category	Points	%	Description
Organization	5	5%	Organization:   Case study responses are presented in a logical format; AND Responses are in sequence with the numbered questions; AND

 

Category	Points	%	Description
			The case study response is understandable and easy to follow; AND All responses are relevant to the case topic
Format	5	5%	Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors*   (*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.
	10	10%	Total FORMAT Points= 10 pts
	100	100%	DISCUSSION TOTAL=         out of 100 points

 

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