The nurse who is caring for a client with acute diverticulitis will immediately report which finding to the health care provider?

Question

Quizplus · Accepted Answer

Diverticula are saclike protrusions or outpouchings of the intestinal mucosa of the large intestine caused by increased intraluminal pressure (chronic constipation). The left (descending, sigmoid) colon is the most common area for diverticula to develop. When these diverticula become inflamed (diverticulitis), the client may experience acute pain (usually in the left lower quadrant) and systemic signs of infection (eg, fever, tachycardia, nausea, leukocytosis). Complications that can occur in some clients are abscess formation (continuous fever despite antibiotics and palpable mass) and intestinal perforation resulting in diffuse peritonitis (progressive pain in other quadrants of the abdomen, rigidity, guarding, rebound tenderness). The client with peritonitis prefers to lie still and take shallow breaths to avoid stretching the inflamed peritoneum. Peritonitis is a potentially lethal complication and should be reported immediately. (Option B) Clients with acute diverticulitis can bleed. Usually this bleeding is quite obvious, often with a large amount of bright red blood seen in the stool. This client's mild anemia is nonspecific and should not be given reporting priority over the peritoneal signs. (Option C) This indicates fetal position and could be due to pain. Clients with peritonitis are expected to lie still as any movement worsens the pain. Peritonitis takes priority over the expected pain in diverticulitis. (Option D) Leukocytosis is expected with acute diverticulitis. However this client's white blood cell count is only minimally elevated (upper limit of normal is 11,000/mm³ [11.0 x 10⁹/L]) and is not a priority over possible peritoneal signs. Educational objective: Diverticulitis is caused by inflammation of diverticula (outpouchings) of the large intestine that can lead to abscess, perforation, peritonitis, and/or bleeding. Peritonitis is a potentially fatal complication that should be reported to the health care provider immediately.

The Nurse Who Is Caring for a Client with Acute