NCLEX RN Practice Question # 632

NCLEX Examination.

Practice Question # 632.



Diverticulitis Review

Diverticulitis is the inflammation of one or more diverticula that occurs from penetration of fecal matter through the thin-walled diverticula; it can result in local abscess formation and perforation.

  1. A perforated diverticulum can progress to intra-abdominal perforation with generalized peritonitis.


  • Left lower quadrant abdominal pain that increases with coughing, straining, or lifting
  • Elevated temperature
  • Nausea and vomiting
  • Flatulence
  • Cramp-like pain
  • Abdominal distention and tenderness
  • Palpable, tender rectal mass may be present.
  • Blood in the stools


  • Provide bedrest during the acute phase.
  • Maintain NPO status or provide clear liquids during the acute phase as prescribed.
  • Introduce a fiber-containing diet gradually, when the inflammation has resolved.
  • Administer antibiotics, analgesics, and anticholinergics to reduce bowel spasms as prescribed.
  • Instruct the client to refrain from lifting, straining, coughing, or bending to avoid increased intra-abdominal pressure.
  • Monitor for perforation (see Box 56-3), hemorrhage, fistulas, and abscesses.
  • Instruct the client to increase fluid intake to 2500 to 3000 mL daily, unless contraindicated.
  • Instruct the client to eat soft high-fiber foods, such as whole grains; the client should avoid high-fiber foods when inflammation occurs because these foods will irritate the mucosa further.
  • Instruct the client to avoid gas-forming foods or foods containing indigestible roughage, seeds, or nuts because these food substances become trapped in diverticula and cause inflammation.
  • Instruct the client to consume a small amount of bran daily and to take bulk-forming laxatives as prescribed to increase stool mass.

Surgical interventions

  • Colon resection with primary anastomosis may be an option.
  • Temporary or permanent colostomy may be required for increased bowel inflammation.

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