Diverticulitis happens when small pouches in the colon wall become inflamed or infected. Clients often have left lower abdominal pain, fever, and changes in bowel habits. Your priorities are pain control, resting the bowel, treating infection, and watching for perforation.
Each care plan below follows the nursing process (ADPIE).
Acute Pain
- Inflammation and infection of the colon pouches
- Left lower quadrant abdominal pain
- Guarding and tenderness
- Client rates pain 7 out of 10
- Grimacing
- Client rates pain at 3 out of 10 or less within 1 hour of treatment
- Client manages discomfort and returns to normal activity
- Pain location, intensity, and quality
- Abdominal tenderness, rigidity, and bowel sounds
- Response to pain medicine
| INTERVENTION | RATIONALE |
|---|---|
| Give pain medicine as ordered and reassess | Controlling pain improves rest and healing. |
| Keep the client NPO or on clear liquids as ordered | Resting the bowel lowers inflammation. |
| Report sudden severe pain or a hard, rigid abdomen right away | These can be signs of perforation and peritonitis. |
| Avoid enemas and laxatives during the acute phase | They raise pressure in the colon and could cause rupture. |
EVALUATION
- Client rates pain at 3 or lower
- Abdomen is soft without rigidity
Risk for Infection
- Inflamed diverticula
- Possible perforation or abscess
- Temperature stays below 38.3 °C (101 °F) within 48 hours of antibiotics
- White blood cell count returns to normal
- Client finishes the full antibiotic course
- Temperature and heart rate every 4 hours
- White blood cell count
- Signs of peritonitis such as rigid abdomen and rebound tenderness
| INTERVENTION | RATIONALE |
|---|---|
| Give antibiotics on time as ordered | On-time doses keep drug levels high enough to fight infection. |
| Advance diet slowly as ordered, from clear liquids to low fiber, then high fiber after recovery | Slow advancement lets the colon heal, and fiber later helps prevent future flares. |
| Teach the client to finish all antibiotics | Stopping early can lead to the infection coming back. |
| Teach high-fiber foods and fluids once healed | Fiber softens stool and lowers pressure in the colon. |
EVALUATION
- Client is afebrile
- WBC is trending to normal
- Client states the plan for diet and antibiotics
Practice this in This vs That
Tell diverticulitis apart from appendicitis and other belly pain look-alikes.
Play This vs ThatQuick answers
Where is diverticulitis pain usually felt?
In the left lower quadrant, because most diverticula form in the sigmoid colon.
What diet is taught after a diverticulitis flare heals?
A high-fiber diet with plenty of fluids. During an acute flare, the bowel rests with clear liquids or low fiber first.
For learning only. Individualize every care plan to your client, and follow your program, current guidelines, provider orders, and facility policy.