NR 507 week 5 case study with References . all quizzes answered
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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) fo...
nr 507 week 5 case study with references all quizzes answered
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NR 507 week 5 case study with References . all quizzes answered
NR507 Week 5 Discussion
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
(100.2 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 is 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 diverticulitis.
Diverticulosis is characterized by sac-like diverticula, which form when
mucosa and submucosa are herniated through defects in the muscle layer of
the large intestinal wall (Elisei & Tursi, 2018). Diverticulitis results from
perforations of the diverticular wall. Diverticulosis is present in approximately
60% of individuals over 60, and diverticulitis occurs in about 25% of those
with diverticulosis (Linzay & Pandit, 2021).
2. Identify the clinical findings from the case that supports a diagnosis of
acute diverticulitis.
Clinical findings from the case that support the diagnosis of acute
diverticulitis are left lower quadrant abdominal pain, constipation, and
nausea.
3. List 3 risk factors for acute diverticulitis.
Three risk factors for acute diverticulitis are physical inactivity, obesity, and
increasing age.
4. Discuss why antibiotics and IV fluids are indicated in this case.
IV fluids and antibiotics are indicated in this case for multiple reasons. The
fluids are needed to help with all of her signs of dehydration (tachycardia,
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