5 Nursing Diagnosis for Diverticulitis (Complete Guide for Nursing Students)
Diverticulitis is an acute inflammatory condition that occurs when diverticula—small pouches formed in the intestinal wall—become infected or inflamed. While diverticular disease is commonly asymptomatic, diverticulitis can lead to severe complications, including perforation, abscess formation, or peritonitis. For nurses, understanding the pathophysiology, clinical manifestations, and appropriate nursing diagnoses is essential for delivering safe and effective care.
What Is Diverticulitis?
Diverticulitis develops when food particles or bacteria become trapped inside the diverticulum, leading to inflammation, infection, and sometimes rupture. While diverticulosis (the presence of diverticula) is usually asymptomatic, diverticulitis often presents with pain, fever, and gastrointestinal disturbances.
Pathophysiology Overview
The formation of diverticula is strongly associated with long-term low fiber intake, which leads to increased colonic pressure and abnormal colonic motility. When stool is retained inside the diverticulum, bacterial growth triggers inflammation.
- Diverticulosis: Multiple non-inflamed diverticula; typically asymptomatic.
- Diverticulitis: Inflammation or infection of a diverticulum; may be acute or chronic.
- Common location: Sigmoid colon.
- Risk increases with age: Especially in adults over 80 years old.
Major Risk Factors
- Low-fiber diet
- Chronic constipation
- Aging and weakening of bowel walls
- Obesity and sedentary lifestyle
- High red meat intake
- Genetic predisposition (especially in younger patients)
Clinical Manifestations of Diverticulitis
Symptoms may vary depending on the severity of the condition. Acute episodes often require hospitalization, especially when complications such as abscess or bleeding occur.
Common Signs and Symptoms
- Left lower quadrant abdominal pain (most common)
- Abdominal tenderness
- Bloating and mild distension
- Constipation or diarrhea
- Fever and chills
- Leukocytosis
- Nausea and vomiting
Complications to Monitor
- Perforation leading to peritonitis
- Abscess formation
- Fistula formation (colovesical fistula)
- Bowel obstruction
- Massive lower gastrointestinal bleeding
Diagnostic Procedures
Diagnosis usually involves clinical evaluation and imaging studies. Barium enema is not recommended during an acute attack due to perforation risks.
Common Diagnostic Tests
- CT Scan: Gold standard, identifies inflammation, abscess, or perforation.
- Ultrasound: Useful for initial evaluation.
- Blood tests: Elevated WBC, CRP.
- Colonoscopy: Performed only after acute inflammation resolves.
5 Nursing Diagnosis for Diverticulitis
The following nursing diagnoses align with NANDA International (NANDA-I) and are commonly used in the management of patients with diverticulitis.
1. Acute Pain related to Inflammation of the Diverticula
Related to: Inflammation, infection, increased colonic pressure.
Evidenced by: Patient reports abdominal pain, guarding, facial grimacing, nervousness.
Nursing Interventions
- Assess pain characteristics (location, intensity, duration).
- Provide prescribed analgesics.
- Encourage the patient to rest the bowel (NPO if severe).
- Apply warm compress to abdomen if allowed.
- Monitor for signs of worsening inflammation (rigid abdomen, rebound tenderness).
2. Constipation related to Narrowing of the Colon
Related to: Thickening of colon walls, decreased motility.
Evidenced by: Bloating, nausea, distended abdomen, hard stools.
Nursing Interventions
- Monitor bowel elimination pattern.
- Encourage high-fiber diet once acute inflammation has resolved.
- Increase fluid intake as tolerated.
- Administer stool softeners as prescribed.
- Promote ambulation to stimulate bowel motility.
3. Imbalanced Nutrition: Less Than Body Requirements
Related to: Loss of appetite, abdominal pain, nausea.
Evidenced by: Reduced food intake (eating only half meals), weight loss.
Nursing Interventions
- Monitor nutritional status and daily calorie intake.
- Introduce clear liquid diet during acute phase.
- Gradually progress to low-fiber diet, then high-fiber diet for prevention.
- Collaborate with a dietitian for meal planning.
- Monitor weight and hydration status.
4. Disturbed Sleep Pattern related to Pain
Related to: Discomfort, abdominal pain.
Evidenced by: Restlessness, difficulty sleeping, anxiety.
Nursing Interventions
- Provide a quiet and comfortable environment.
- Administer analgesics before sleep.
- Teach relaxation techniques.
- Identify factors affecting sleep (noise, anxiety, pain).
5. Anxiety related to Disease Condition and Pain
Related to: Fear of complications, pain.
Evidenced by: Patient appears anxious, nervous, or restless.
Nursing Interventions
- Provide clear explanations of procedures and care plan.
- Encourage the patient to express concerns.
- Use therapeutic communication techniques.
- Teach deep breathing exercises.
- Involve family members for emotional support.
Example Case Study (for Nursing Students)
Patient: Male, 62 years old
Symptoms: Left lower quadrant pain, low-grade fever, nausea.
Diagnostic results: CT scan confirms acute diverticulitis.
Nursing Priorities
- Manage acute pain.
- Monitor infection indicators (WBC, temperature).
- Provide IV antibiotics as prescribed.
- Maintain NPO until pain decreases.
Health Education for Patients
- Increase fiber intake after recovery (fruits, vegetables, whole grains).
- Drink 1.5–2 liters of water daily.
- Avoid seeds and nuts only if advised by a provider.
- Exercise regularly.
- Limit red meat and processed foods.
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Conclusion
Diverticulitis is a common but potentially serious gastrointestinal condition that requires prompt assessment, accurate nursing diagnosis, and appropriate interventions. Understanding the pathophysiology, risk factors, clinical signs, and priority nursing diagnoses helps nurses provide comprehensive and patient-centered care. The five nursing diagnoses listed—acute pain, constipation, imbalanced nutrition, disturbed sleep pattern, and anxiety—represent the core focus areas when managing patients with diverticulitis. Through effective nursing interventions, patient outcomes can significantly improve, and complications can be prevented.
Sources
- Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 13th Edition.
- Sjamsuhidajat, R. (2007). Buku Ajar Ilmu Bedah.
- Sabiston Textbook of Surgery, 19th Edition.
- Painter, N.S. (2013). Diverticular Disease of the Colon.
- NANDA International Nursing Diagnoses 2021–2023.
