1 nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com Diverticular Disease Elizabeth Boldon, RN, MSN Elizabeth Boldon is a Nurse Education Specialist at Mayo Clinic in Rochester, Minnesota. She received a BSN from Allen College in Waterloo, Iowa in 2002 and an MSN with a focus in education from the University of Phoenix in 2008. She has bedside nursing experience in medical neurology and the neuroscience ICU. Abstract Diverticular disease is a common disease associated with significant potential complications. Colonoscopy, X-rays and possibly computed tomography (CT) assist in the diagnosis of diverticulosis and potential complications. Initial therapy and treatment of complications, such as infection and bleeding, related to diverticulosis are discussed, which includes endoscopic and surgical interventions.
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Diverticular Disease - NurseCe4Less.com · 28/12/2015 · Diverticulosis and diverticular disease are common in Western and industrialized countries — particularly the United States,
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Elizabeth Boldon is a Nurse Education Specialist at Mayo Clinic in Rochester, Minnesota. She received a BSN from Allen College in Waterloo, Iowa in 2002 and an MSN with a focus in education from the University of Phoenix in 2008. She has bedside nursing experience in medical neurology and the neuroscience ICU.
Abstract
Diverticular disease is a common disease associated with significant potential
complications. Colonoscopy, X-rays and possibly computed tomography (CT)
assist in the diagnosis of diverticulosis and potential complications. Initial
therapy and treatment of complications, such as infection and bleeding,
related to diverticulosis are discussed, which includes endoscopic and
1. Diverticulosis specifically describes a. the presence of diverticula with symptoms. b. the presence of diverticula. c. the presence of diverticula with diverticular bleeding. d. inflammation of a diverticulum.
2. Inflammation of a diverticulum, known as
___________________ occurs when there is thinning and breakdown of the diverticular wall. a. diverticulosis b. colitis c. diverticulitis d. diverticular bleeding
3. A fistula is
a. a localized collection of pus. b. an abnormal tract between two areas that are not normally
connected. c. a blockage of the colon. d. an infection around the abdominal organ.
4. Sepsis is defined as
a. an abnormal tract between two areas that are not normally
connected. b. an infection around the abdominal organ. c. a blockage of the colon. d. an overwhelming body-wide infection.
5. Diverticular bleeding occurs
a. when a small artery in a diverticulum erodes/bleeds into the colon. b. in 25% of cases of simple diverticulitis. c. in 75 percent of all cases of diverticulitis. d. All of the above.
The American Dietetic Association recommends 20 to 35 grams of fiber a
day. Every person, regardless of the presence of diverticula, should try to
consume 20 to 35 grams of fiber every day. Fiber is the indigestible part of
plant foods. High-fiber foods include whole grain breads, cereals, and
crackers, berries, fruit, vegetables (such as broccoli, cabbage, spinach,
carrots, asparagus, squash, and beans), brown rice, bran products, and
cooked dried peas and beans, among other foods. Drinking eight 8-ounce
glasses of water a day, monitoring changes in bowel movements (from
constipation to diarrhea) and getting enough rest and sleep, are other ways
to prevent diverticular disease.2
Summary
In summary, diverticular disease consists of three conditions that involve the
development of small sacs or pockets in the wall of the colon diverticulum)
including diverticulosis, diverticular bleeding, and diverticulitis. This course
has discussed these conditions, as well as their symptoms, causes, risk
factors, diagnosis, complications and treatment.
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1. Diverticulosis specifically describes a. the presence of diverticula with symptoms. b. the presence of diverticula. c. the presence of diverticula with diverticular bleeding. d. inflammation of a diverticulum.
2. Inflammation of a diverticulum, known as ____________ occurs
when there is thinning and breakdown of the diverticular wall. a. diverticulosis b. colitis c. diverticulitis d. diverticular bleeding
3. A fistula is
a. a localized collection of pus. b. an abnormal tract between two areas that are not normally
connected. c. a blockage of the colon. d. an infection around the abdominal organ.
4. Sepsis is defined as
a. an abnormal tract between two areas that are not normally
connected. b. an infection around the abdominal organ. c. a blockage of the colon. d. an overwhelming body-wide infection.
5. Diverticular bleeding occurs
a. when a small artery in a diverticulum erodes and bleeds into the
colon. b. in 25% of cases of simple diverticulitis. c. in 75 percent of all cases of diverticulitis. d. in all of the above.
6. True or False: A low-fiber diet is associated with diverticulosis
and an increased chance of diverticula. a. True b. False
7. In the colon, inflammation may be caused by ________________________. a. a decrease in healthy bacteria. b. a decrease in disease-causing bacteria. c. an increase in disease-causing bacteria. d. both a and c.
8. ____________ has been associated with an increase in risk of
both diverticulitis and diverticular bleeding. a. A low-fiber diet b. Lack of exercise c. Obesity d. Corn or popcorn consumption
9. ____________ appears to increase the risk for perforated
diverticulitis and a diverticular abscess. a. Smoking b. Consuming caffeine c. Alcohol consumption d. Inactivity
10. In testing for diverticular disease, a blood test may be ordered
by the healthcare provider to determine a. the presence of diverticula. b. the level of healthy bacteria. c. the presence of inflammation or anemia. d. levels of blood-alcohol.
11. Which of the following is the most common test used to
diagnose diverticular disease? a. Flexible sigmoidoscopy b. Computerized tomography (“CT”) scan of the colon c. Lower gastrointestinal (“GI”) series d. Colonoscopy
12. For several days, the patient’s stools may be white or light-colored because of ___________ in the large intestine after an enema. a. statins b. bacteria c. water d. barium
13. ______________________ is/are associated with an increased
risk of diverticulitis and diverticular bleeding. a. Statins b. Higher levels of vitamin D c. Alcohol consumption d. Steroids
14. One complication of acute diverticulitis may be
________________, which involves spilling intestinal contents into the abdominal cavity. a. peritonitis b. sepsis c. a fistula d. colitis
15. The usual treatment for a patient with diverticulitis who
develops an abscess is a. to drain the abscess. b. to surgically remove the abscess. c. to remove a small part of the intestine. d. to treat the patient with antibiotics.
16. Which of the following is true of diverticular bleeding?
a. It is common for patients with diverticulitis. b. It may stop by itself and not require treatment. c. Bleeding is never severe. d. A patient need only see a healthcare provider if the bleeding is
17. The American Dietetic Association recommends __________ grams of fiber a day. a. more than 50 b. 20 to 35 c. 10 d. 40 to 50
18. An procedure called __________________________ uses small
incisions, rather than the typical vertical abdominal incision, to treat diverticulitis. a. an angiogram b. flexible sigmoidoscopy c. laparoscopic surgery d. a colostomy
19. Diverticular disease involves the presence of _______________
in the wall of the colon. a. disease-causing bacteria b. bleeding c. small sacs or pockets d. an abscess
20. True or False: When treating diverticulosis, combining
mesalazine with the antibiotic rifaximin (Xifaxan) can be significantly more effective than using rifaximin alone. a. True b. False
b. the presence of diverticula. “Diverticulosis merely describes the presence of diverticula.”
2. Inflammation of a diverticulum, known as ____________ occurs when there is thinning and breakdown of the diverticular wall.
c. diverticulitis “Inflammation of a diverticulum (diverticulitis) occurs when there is thinning and breakdown of the diverticular wall.”
3. A fistula is
b. an abnormal tract between two areas that are not normally connected. “Fistula - an abnormal tract between two areas that are not normally connected (i.e., bowel and bladder).”
4. Sepsis is defined as
d. an overwhelming body-wide infection. “Sepsis – overwhelming body-wide infection that can lead to failure of multiple organs.”
5. Diverticular bleeding occurs
a. when a small artery in a diverticulum erodes and bleeds into the colon. “Diverticular bleeding occurs when a small artery located within a diverticulum is eroded and bleeds into the colon.”
6. True or False: A low-fiber diet is associated with diverticulosis and an increased chance of diverticula.
b. False “Scientists are not certain what causes diverticulosis and diverticular disease. For more than 50 years, the most widely accepted theory was that a low-fiber diet led to diverticulosis and diverticular disease. Two large studies also indicate that a low-fiber diet may increase the chance of developing diverticular disease. However, a recent study found that a low-fiber diet was not associated with diverticulosis and that a high-fiber diet and more frequent bowel movements may be linked to an increased rather than decreased chance of diverticula.”
7. In the colon, inflammation may be caused by
________________________.
a. a decrease in healthy bacteria. b. a decrease in disease-causing bacteria. c. an increase in disease-causing bacteria. d. both a and c. [Correct answer]
“In the colon, inflammation also may be caused by a decrease in healthy bacteria and an increase in disease-causing bacteria. This change in the bacteria may permit chronic inflammation to develop in the colon.”
8. ____________ has been associated with an increase in risk of
both diverticulitis and diverticular bleeding.
c. Obesity “Obesity has been associated with an increase in risk of both diverticulitis and diverticular bleeding.”
9. ____________ appears to increase the risk for perforated diverticulitis and a diverticular abscess.
a. Smoking “Current smokers appear to be at increased risk for perforated diverticulitis and a diverticular abscess as compared with nonsmokers. Caffeine and alcohol are not associated with an increased risk for symptomatic diverticular disease.”
10. In testing for diverticular disease, a blood test may be ordered by the healthcare provider to determine
c. the presence of inflammation or anemia. “The hemoglobin and complete blood count (CBC) blood test can show the presence of inflammation or anemia — a condition in which red blood cells are fewer or smaller than normal, which prevents the body’s cells from getting enough oxygen.”
11. Which of the following is the most common test used to
diagnose diverticular disease?
b. Computerized tomography (“CT”) scan of the colon “A CT scan is often used to diagnose diverticulitis and its complications. If diverticulitis (not just diverticulosis) is suspected, the above three tests should not be used because of the risk of perforation.”
12. For several days, the patient’s stools may be white or light-
colored because of ___________ in the large intestine after an enema.
d. barium “An enema involves flushing water or laxative into the rectum using a special squirt bottle…. For several days, traces of barium in the large intestine can cause stools to be white or light-colored.”
13. ______________________ is/are associated with an increased
risk of diverticulitis and diverticular bleeding.
d. Steroids “Several medications are associated with an increased risk of diverticulitis and diverticular bleeding including nonsteroidal anti-inflammatory drugs, steroids, and opiates.”
14. One complication of acute diverticulitis may be ________________, which involves spilling intestinal contents into the abdominal cavity.
a. peritonitis “Peritonitis [is] a medical emergency that requires immediate care, which can occur if the infected or inflamed pouch ruptures, spilling intestinal contents into the abdominal cavity.”
15. The usual treatment for a patient with diverticulitis who
develops an abscess is
d. to treat the patient with antibiotics. “Antibiotic treatment of diverticulitis usually prevents or treats an abscess. If the abscess is large or does not clear up with antibiotics, it may need to be drained.”
16. Which of the following is true of diverticular bleeding?
b. It may stop by itself and not require treatment. “Diverticular bleeding is rare. Bleeding can be severe; however, it may stop by itself and not require treatment.”
17. The American Dietetic Association recommends __________
grams of fiber a day.
b. 20 to 35 “The American Dietetic Association recommends 20 to 35 grams of fiber a day. Every person, regardless of the presence of diverticula, should try to consume 20 to 35 grams of fiber every day.”
18. An procedure called __________________________ uses small
incisions, rather than the typical vertical abdominal incision, to treat diverticulitis.
c. laparoscopic surgery “In many cases, an elective operation can be performed laparoscopically, using small incisions, rather than the typical vertical
abdominal incision. Laparoscopic surgery usually allows for a faster recovery and a shorter hospital stay.”
19. Diverticular disease involves the presence of _______________
in the wall of the colon.
c. small sacs or pockets “Diverticular disease consists of three conditions that involve the development of small sacs or pockets in the wall of the colon (called diverticulum) including diverticulosis, diverticular bleeding, and diverticulitis.”
20. True or False: When treating diverticulosis, combining
mesalazine with the antibiotic rifaximin (Xifaxan) can be significantly more effective than using rifaximin alone.
a. True “Research has also shown that combining mesalazine with the antibiotic rifaximin (Xifaxan) can be significantly more effective than using rifaximin alone to improve a person’s symptoms and maintain periods of remission.”
The References below include published works and in-text citations of published works that are intended as helpful material for your further reading.
1. Diverticular Disease (2013) National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved December 28, 2015 from www.niddk.nih.gov
2. Diverticulitis (2014) Mayo Foundation for Medical Education and Research. Retrieved December 18, 2015 from www.mayoclinic.org
3. Pemberton, J.H. & Young-Fadok, T. (2015) Clinical manifestations and diagnosis of acute diverticulitis in adults, in Lamont, J.T. (Ed.), UpToDate. Waltham, Mass.: UpToDate. Retrieved December 19, 2015 from www.uptodate.com
4. Young-Fadok, T. & Pemberton, J.H. (2015) Colonic diverticulosis and diverticular disease: Epidemiology, risk factors, and pathogenesis, in Friedman, L.S. (Ed.), UpToDate. Waltham, Mass.: UpToDate. Retrieved December 19, 2015 from www.uptodate.com
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