Case Study- diverticular disease
Details: Case Scenario:
An 84- year-old -a 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 constipation, nausea, vomiting, and a low-grade fever (100.20 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 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:
The stool for occult blood is positive.
A flat plate abdominal x-ray demonstrates a bowel-gas pattern consistent with an ileus.
An abdominal CT scan with contrast shows no evidence of a mass or abscess. The 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:
Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis.
List 3 risk factors for acute diverticulitis.
Discuss why antibiotics and IV fluids are indicated in this case.
Week 5: Discussion
Purpose
The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
Compare and contrast the pathophysiology of diverticular disease (diverticulosis) and acute diverticulitis. (CO1)
Identify risk factors for acute diverticulitis and the clinical signs and symptoms associated with the disease. (CO3)
Explain the significance of physical exam and diagnostic findings in the diagnosis of diverticular disease. (CO4)
Due Date:
Initial post is due on Wednesday by 11:59 p.m. MT. All posts are due by Sunday, 11:59 p.m. MT
A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.
Total Points Possible: 100
Requirements:
Read the case study below.
In your initial discussion post, answer the questions related to the case scenario and support your response with at least one evidence-based reference by Wed., 11:59 pm MT.
Respond to at least one peer and all faculty questions directed at you, using appropriate resources, before Sun., 11:59 pm MT.
Case Scenario:
An 84- year-old -a 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 constipation, nausea, vomiting, and a low-grade fever (100.20 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:
The stool for occult blood is positive.
A flat plate abdominal x-ray demonstrates a bowel-gas pattern consistent with an ileus.
An abdominal CT scan with contrast shows no evidence of a mass or abscess. Small bowel in 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:
Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis.
List 3 risk factors for acute diverticulitis.
Discuss why antibiotics and IV fluids are indicated in this case.
Category Points % Description
Application of Course Knowledge
30
30%
The student:
Compares and contrasts the pathophysiology between diverticular disease (diverticulosis) and acute diverticulitis.
Identifies the clinical findings from the case that supports a diagnosis of acute diverticulitis.
Lists 3 risk factors for acute diverticulitis.
Discuss why antibiotics and IV fluids are indicated in this case.
Support from Evidence-Based Practice
30
30%
Initial discussion post is supported with appropriate, scholarly sources; AND
Sources are published within the last 5 years (unless it is the most current CPG); AND
The reference list is provided and in-text citations match; AND
All answers are fully supported with an appropriate EBM argument
Interactive Dialogue
30
30%
In addition to providing a response to the initial post due by Wednesday, 11:59 p.m. MT, student provides a minimum of two responses weekly on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question. A response to faculty could include a question posed to a student or the entire class or a faculty question directed towards another student. AND
Evidence from appropriate scholarly sources are included; AND
The reference list is provided and in-text citations match
90
90%
Total CONTENT Points= 90 pts
DISCUSSION FORMAT
Category
Points
%
Description
Organization
5
5%
Organization:
Case study responses are presented in a logical format; AND
Responses are in sequence with the numbered questions; AND
The case study response is understandable and easy to follow; AND
All responses are relevant to the case topic
Format
5
5%
Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors*
(*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.
10
10%
Total FORMAT Points= 10 pts
100
100%
DISCUSSION TOTAL=____ out of 100 points
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